The most commonly used clinical definition of infertility is the failure to conceive after 12 months of regular unprotected intercourse. This is the general threshold after which a couple should seek a fertility evaluation, and it applies to women under the age of 35 who have no known reproductive health conditions.
For women aged 35 or older, the threshold shortens to six months. This is not simply a guideline — it reflects the biological reality that ovarian reserve declines with age and that time spent investigating is time well spent when the reproductive window is narrowing.
There are also situations where I recommend earlier evaluation regardless of how long the couple has been trying. These include:
- Irregular, infrequent, or absent menstrual periods - which may indicate ovulation problems including PCOS or thyroid dysfunction
- A known or suspected history of pelvic inflammatory disease, endometriosis, or previous pelvic surgery
- A previous ectopic pregnancy or known tube damage
- A history of recurrent miscarriage - two or more pregnancy losses
- A male partner with a known history of testicular injury, surgery, or conditions that may affect sperm production
- Any medical condition in either partner that is known to affect fertilityIn my practice at Birthright Fertility, Banjara Hills, Hyderabad, I always tell couples that seeking an evaluation early does not mean committing to treatment. It means understanding what is happening. Sometimes the evaluation provides reassurance. Sometimes it identifies a treatable problem quickly. Either way, knowing is always better than waiting without information.
Written by Dr Sudharani Bairraju, MBBS (Sri Venkateswara Medical College, Tirupathi, 1997), DNB Obstetrics and Gynaecology (St Theresa's General Hospital, Hyderabad, 2007), Postgraduate Certification in Clinical Embryology, Fellowship in Minimally Invasive Surgeries, Fellowship in Advanced Gynaecological Endoscopy, Senior Consultant Obstetrician and Gynaecologist, Infertility (IVF) Specialist and Laparoscopic Surgeon, Birthright Fertility by Rainbow Hospitals, Banjara Hills, Hyderabad.
