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    When is it time to see a specialist?
    Yvette Smith, MD, MPH posted:
    This decision depends mostly on your goals and preferences. It is essential that you keep the lines of communication open with your partner. Do you know each other's goals? Do you know each other's limits?

    Which of the following stages are you in at this time?

    1. Not really trying, but not avoiding pregnancy, either: The natural consequence of having sex and not actively avoiding pregnancy is achieving a pregnancy. No need to over-think this level, until you realize you are ready to actively pursue pregnancy. But you get credit for being in this level.

    2. Have been trying to conceive: If you are under 35 and have been trying to conceive for one year, or if you're over 35 and have been trying to conceive for 6 months, it's time to move on to the next level, which is infertility testing. (Include the time you were not "really trying" for pregnancy). Again, if you were not actively avoiding pregnancy, you were trying -- and it counts.

    3. Have had all of the testing and no obvious problem was found: This level includes temperature charting, watching mucus, timed intercourse, and ovulation predictor kits or machines. It's probably time to at least talk about what other options you have. Consider an infertility consultation at this point to discuss your options.

    4. Have established problems with ovulation and are trying the milder fertility drug, clomiphene citrate: If you have taken a dose of clomiphene citrate that produced ovulation, consider taking it for three months. If you have not become pregnant in this amount of time, it's probably time to consider a consultation with an infertility specialist.

    WARNING: Be careful about advertisements that include infertility treatments as part of services offered. There are many ways to treat infertility and many physicians can participate in these treatments. Your OB/Gyn, or perhaps your general practitioner, can do much of the initial testing and even treatment. There is a separate subspecialty for Reproduction and Infertility that indicates specialty training in this area. If you think you are seeing a specialist, confirm that they are trained, board eligible, or certified in this subspecialty.

    Some couples will never be ready to move to the fertility specialists. For some people it all sounds too medical and scientific. For some people it all sounds too expensive. Some people want to believe that a little more time will fix things. Some people object to the testing.
    Have you tried to conceive for more than a year? What may be stopping you from seeing a fertility specialist?

    Helpful Tips

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    For more information, visit the Duke Fertility Center