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    Mother Nature vs. Infertility Treatment

    Still not pregnant? When to seek infertility treatment and when to let nature take its course.

    When to Get the Full Infertility Workup

    After trying for one year, doctors may recommend a full infertility workup. They may opt to do this sooner if the couple is aged 35 or older, says Mindy Shaffran, MD, a reproductive specialist at East Coast Fertility in Plainview, N.Y.

    "After the age of 35, it is recommended that couples try for six months instead of a year," she says. "The majority of couples will be successful in that time, and if you are not, there may be things that we want to catch sooner rather than later."

    "Fertility declines rapidly after age 35 and sometimes it gets to the point where we can't really help," she says. "It behooves women in this age group to start the process earlier even if they would have gotten pregnant on their own so they know that there is not any particular problem that they need to overcome," she says.

    There are many possible causes of infertility, and a full workup will try to identify exactly which is causing the problem. Doctors will examine potential causes of both male infertility and female infertility. The results will help dictate and guide infertility treatment.

    The process starts by consulting an infertility specialist, like Shaffran. The full workup will entail a semen analysis for the man. In women, the infertility workup consists of blood testing to check levels of thyroid hormone and other hormones, a Pap test to check for changes in the cells of the cervix or infection, and a hysterosalpingogram (HSG), an X-ray procedure that makes sure that the fallopian tubes are open. The HSG can also detect any abnormalities in the uterus.

    Sabanegh often suggests that men get tested first. "Routine semen analysis is quick and relatively inexpensive," he tells WebMD. "Before we put women through invasive, expensive, and painful tests, we better have a pretty good idea that those tests are necessary," he says.

    For couples who want to complete the evaluation as rapidly as possible, Shaffran says she will initiate a workup on both partners simultaneously. "Many couples will often have more than one factor at the root of their infertility."

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