About 85% of couples get pregnant after a year of trying. It could still happen ‘naturally’ (at two years it’s over 90%) but if you have been trying for more than one year or more (under 35 years of age), 6 months or more (36-40 years of age) or if you are over 40 years of age this is a good time to see a Fertility specialist (Reproductive Endocrinology/Infertility or REI) to find out why your partner is not getting pregnant and to help you to get to that first child.
REI physicians train in Ob/Gyn before specializing in fertility medicine. They can do tests to check the number of eggs left in the female partner’s ovaries (ovarian reserve) which can go down as women get older. She should also be checked for hormonal problems which can stop her from getting pregnant including thyroid problems or polycystic ovarian syndrome (PCOS), and the MD will check her uterus for fibroids or polyps and perform a hysterosalpingogram or HSG test to make sure that her fallopian tubes are both open and look normal.
It takes two to get pregnant of course, and the man has a sperm problem in 40-50% of couples trying to conceive, so you will need a semen analysis (sperm test). If there is a sperm issue, it may be the only reason that the female partner is not pregnant yet, or a contributing factor along with problems on the female side. Most REI docs like to see you both partners as a couple, but it is not mandatory that you come to the first visit.
After these tests there are specific treatments for improving fertility depending on the cause(s) we find, such as Clomid can help her ovulate (release an egg) or release more than one egg in a month. Clomid can be combined with Intrauterine Inseminations (IUI) where the sperm is washed and placed inside her uterus. Some couples may need more intensive treatment such as In Vitro Fertilization (IVF).
In short, see a specialist for testing and to come up with an individualized treatment plan to help your wife get pregnant. Lifestyle changes may help if needed as well – quit smoking, avoid heavy drinking and drug, and aim for a normal weight applies to both of you.
It is now possible for women interested in knowing their reproductive potential to obtain a detailed fertility assessment. Our new Fertility Snapshot program lets women know just how easily they will be able to get pregnant in the next couple of years without going through costly testing.