A fertility evaluation is designed to identify factors that may be making pregnancy more difficult. It is not one single test, and it does not always lead immediately to advanced fertility treatment.

For many patients, the process begins with a careful conversation and a step-by-step plan.

Your Menstrual and Medical History

Your provider may ask about:

• How long you have been trying to conceive
• How often you have intercourse
• Cycle length and regularity
• Previous pregnancies or miscarriages
• Pelvic infections
• Endometriosis symptoms
• Prior surgeries
• Medications and supplements
• Family history
• Chronic medical conditions

Bring information about recent periods and any ovulation testing you have completed.

Evaluating Ovulation

Regular monthly periods often suggest that ovulation is occurring, but they do not guarantee it. Depending on your history, your provider may recommend:

• Progesterone testing
• Thyroid testing
• Prolactin testing
• Testing for PCOS
• Ovulation predictor kits
• Ultrasound monitoring in selected cases

Antimüllerian hormone, commonly called AMH, may provide information about ovarian reserve, but it cannot determine egg quality or guarantee whether natural conception will occur.

Examining the Uterus and Ovaries

A pelvic ultrasound may be used to evaluate:

• Uterine fibroids
• Endometrial polyps
• Ovarian cysts
• Signs associated with PCOS
• Ovarian reserve
• Uterine structure

Your provider may also recommend a test to evaluate whether the fallopian tubes are open and whether the uterine cavity has a normal shape.

Semen Analysis Is Important

Fertility is a shared health concern. A semen analysis may evaluate sperm concentration, movement, and shape.

Completing this testing early can prevent unnecessary delays or procedures for the female partner.

When Should Testing Begin?

ACOG recommends evaluation after one year of regular intercourse without pregnancy for women younger than 35. For women older than 35, evaluation is generally recommended after six months. Testing may begin sooner when there are irregular cycles, known reproductive conditions, or other risk factors.

What Happens After the Evaluation?

Treatment depends on the findings and your goals. Options may include:

• Timing intercourse around ovulation
• Treating a thyroid or hormonal condition
• Medication to support ovulation
• Treating fibroids or polyps
• Managing endometriosis
• Referral to a reproductive endocrinologist
• Intrauterine insemination or in vitro fertilization

Not every patient needs every test or treatment. Your age, symptoms, preferences, insurance coverage, and reproductive goals should be considered.

Women’s Health and Menopause Center offers comprehensive gynecologic care and can help patients understand when fertility testing may be appropriate.

Contact our West Bloomfield office to begin a personalized conversation about your fertility journey.

The post What Happens During a Fertility Evaluation? appeared first on Women's Health and Menopause Center.

Many women become pregnant and have healthy babies after age 35. However, fertility changes with age, so it can be helpful to approach pregnancy planning with clear information and a realistic timeline.

Seeking guidance does not mean that something is necessarily wrong. It allows you to identify potential concerns early and make informed decisions.

Why Fertility Changes With Age

Women are born with a finite number of eggs. Over time, both egg quantity and egg quality decline. Ovulation may remain regular, but the chance of conception during each cycle generally decreases with age.

The risk of miscarriage and chromosome-related conditions also rises gradually. Age is only one factor, though. Fertility may also be affected by:

• Ovulation disorders
• Endometriosis
• Fibroids
• Blocked fallopian tubes
• Previous pelvic infection
• Thyroid conditions
• Sperm-related factors
• Lifestyle and medical conditions

When Should You Request an Evaluation?

ACOG generally recommends a fertility evaluation after:

• 12 months of trying for women younger than 35
• Six months of trying for women older than 35
• A more immediate discussion for women older than 40

Earlier evaluation may be appropriate at any age if you have irregular periods, known endometriosis, previous pelvic surgery, recurrent pregnancy loss, or a history that may affect fertility.

What Can You Do Before Trying?

A preconception visit may include:

• Reviewing medications and supplements
• Discussing a prenatal vitamin with folic acid
• Updating recommended vaccines
• Managing diabetes, blood pressure, or thyroid disease
• Reviewing menstrual cycles
• Discussing genetic carrier screening
• Addressing tobacco, alcohol, or substance use
• Reviewing family and pregnancy history

Do not discontinue a necessary prescription medication without speaking with the prescribing clinician. Many health conditions are safest when they remain well controlled during pregnancy.

How Often Should You Try?

Having intercourse regularly throughout the cycle may be less stressful than trying to predict one exact day. Ovulation predictor kits can help when cycles are regular, but they may be more difficult to interpret for women with irregular ovulation or PCOS.

Tracking your cycle can still provide useful information for your appointment.

Fertility Care Should Include Both Partners

A fertility evaluation is not only focused on the woman. Sperm-related factors are common and may be evaluated early in the process.

Testing may include ovulation assessment, blood work, pelvic ultrasound, uterine or tubal evaluation, and semen analysis.

Planning With Confidence

Age-related fertility information should guide care, not create panic. Some women conceive quickly after 35, while others benefit from additional support.

Women’s Health and Menopause Center provides comprehensive gynecologic care and personalized pregnancy planning.

To discuss fertility concerns or prepare for pregnancy, schedule an appointment with our West Bloomfield OB-GYN team.

The post Trying to Conceive After 35: When Should You Talk to Your OB-GYN? appeared first on Women's Health and Menopause Center.