When should I get my fertility checked?

If you are trying now

The guidance from the American College of Obstetricians and Gynecologists and the American Society for Reproductive Medicine is the same. If you are under 35, get an evaluation after 12 months of regular unprotected sex without a pregnancy. If you are 35 or older, after 6 months. If you are over 40, an evaluation right away is reasonable.

The shorter timelines are not a judgement. Time matters more as egg supply and egg quality decline, so it makes sense to look sooner.

Reasons to go sooner

Whatever your age, do not wait out the clock if any of these apply to you.

• Periods that are very irregular or absent.
• Known or suspected endometriosis, or severe period or pelvic pain.
• Polycystic ovary syndrome.
• Past pelvic surgery or pelvic infection.
• Chemotherapy or radiation, past or planned.
• A mother or sister who went through menopause before 40.
• Two or more miscarriages.
• A partner with a known sperm problem.

If you are not trying yet

There is no official age for a proactive fertility check. Many doctors suggest one in your late twenties or early thirties if you expect to wait before having children, because the results can still change your plans: whether to freeze eggs, how long to wait, or simply whether you can stop worrying.

Be clear about its limits. A good result is not a promise for later years, and a low egg count does not mean you cannot conceive. What it gives you is a starting point that is yours, instead of an average.

What an assessment includes

Usually a conversation about your cycle and your health history, blood tests for hormones such as AMH, FSH and estradiol, and a pelvic ultrasound to look at your ovaries and uterus. If you have a male partner, a semen analysis belongs in the first round too. A male factor is involved in up to half of couples who have trouble conceiving, and the test is simple.