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The inability to get pregnant can be heartbreaking especially if you’ve been trying for some time. But there are things you can and should do. Sometimes it is easy to diagnose the cause of infertility and treat it.

How do you know it’s time to seek help? If you’re below 35 and have been trying to get pregnant for over one year, or if you’re above 35 and have been trying for about six months. If you’ve experienced two or more consecutive miscarriages, you should see a professional.

Also seek medical attention if you have risk factors for infertility or if you’ve been experiencing unusual and worrisome symptoms, even if you haven’t been trying to conceive for an entire year.

Step 1: Make an appointment with your OB/GYN

Your first step will be to see your regular gynaecologist. Not need to head straight for a fertility clinic. In fact, most fertility clinics would prefer a referral from a primary physician or gynaecologist.

Although it’s not necessary at this point, you may want to bring your partner along. Gather the following information for the appointment.

The dates of your last six periods, even if you experience clock-like menstruation. If you’ve been keeping a basal body temperature chart or a fertility calendar, bring the last six months information.

When you list out your symptoms, make sure to include the embarrassing ones as well, such as low libido, unwanted hair growth, or painful sex.

These can all pass for infertility symptoms. Also, include any symptom experienced by your male partner. Up to 40 percent of infertile couples are faced with male infertility.

Step 2: Begin basic fertility testing

Fertility testing includes a semen analysis for the man and blood work for the woman. Depending on your symptoms, testing may consist of diagnostic laparoscopy, vaginal ultrasound or an HSG.

Your physician may also perform a basic pelvic exam, Pap smear, and some specific tests for sexually transmitted diseases and infections.

Basic fertility tests may or may not produce a diagnosis. Studies show that up to 30 percent of couples never get to find out the cause of their infertility. In which case, they’re diagnosed with unexplained infertility.

It’s normal to feel worried and anxious when undergoing fertility testing. Seek support from family, a friend or therapist. An online fertility forum or an in-person support group can also render emotional support.

Step 3: Begin primary fertility treatment (optional)

Based on the outcome of your fertility tests, your physician may advise you to go ahead with some form of fertility treatment.

For instance, he may feel that you could be successful if you take certain fertility medications such as Femara (letrozole) a breast cancer drug that boosts estrogen levels, Clomid (clomiphene), or Metformin, an insulin-sensitizing drug primarily used for the treatment of diabetes, can also be used for the treatment of infertility sometimes, along with Clomid.

If the test results show that you have structural abnormalities or your uterus, for instance) or endometriosis, your physician may recommend surgical treatment, or perhaps refer you directly to a reproductive surgeon or fertility centre. Keep in mind that certain lifestyle changes could improve your chances of conceiving while you undergo treatment (even if you decide not to).

These include, reduction of alcohol intake, quitting smoking, losing weight if you’re overweight or obese (keep in mind that obesity can also be ignited by hormonal imbalance) and even cutting down on the amount of exercise you do, especially if you’re underweight or you tend to work out excessively.

Step 4: Graduate to a fertility clinic

If basic fertility treatments fail or if your test results point to procedures that go beyond your gynaecologist’s purview, she may refer you to a fertility clinic or fertility specialist.

Because your fertility treatment would likely not be covered by your insurance, you should focus your search for a clinic or doctor on finding the best possible treatment that you can afford.

When you start calling fertility centres or looking at their website, make sure you’re certain of how much the initial consultation will cost. If you choose to go ahead with treatment, discuss fees before they begin.

If you’re choosing a clinic that is not close by, then you should consider the loss of work time and travel expenses.

Step 5: More fertility tests

Often (but not always) your fertility expert might want to conduct more tests or even rerun some tests that you’ve already done.

For instance, your gynaecologist or physician may have checked your FSH levels, while the fertility centre may also choose to run an antral follicle count or conduct another ovarian reserve test.

If you’ve ever had a miscarriage, your gynaecologist may have sent the tissue from the miscarriage for analysis while the fertility centre may suggest a hysteroscopy or karyotyping.

Step 6: Create a plan of action

After receiving the results of any repeated or second round of tests, your fertility specialist will go over a recommended treatment plan.

After you discuss with her, you may also need to meet the clinics financial advisor to discuss the payment options and fees. Your specialist should give you and your partner time to go over the proposed treatment and figure out what you can afford.

Step 7: Begin fertility treatment plans

Infertility treatments have different levels. From relatively simple, to complicated and involved. For instance, if you have endometriosis, your doctor may remove endometrial deposits first through a surgical operation.

Then after you have time to recuperate, you may begin IVF or even try on your own for a while.

Step 8: Reevaluate treatment plans if unsuccessful

Fertility treatment is less of a bull’s eye solution and more of a try-this-try-that process. You may get pregnant during your very first treatment cycle. But it is more likely you would need a couple of cycles before you succeed.

One failed cycle doesn’t imply that treatment will never work. In fact, couples without fertility issues may need three to six months to get pregnant.

A good fertility doctor will help you understand when to stick to current treatment or when it’s necessary to make minor or major adjustments to the procedure. There are also suggested limits to treatments. For instance, Clomid shouldn’t be taken for more than six cycles.

If you start feeling overwhelmed but not ready to give up just yet, talk to your physician about taking a break. You may be worried that the chances of success my slim out by delaying treatment, but it’s not always true. Besides, your mental health should come first.

Step 9A: plan for a healthy pregnancy

If treatments succeed and you’re able to conceive, the fertility centre will likely keep an eye on the pregnancy for the first couple of weeks, and you may need to continue some hormonal injections or treatments.

Depending on the cause of your fertility problem or if you’re carrying multiples, you may need closer monitoring throughout the pregnancy period. Pregnancy after infertility can’t be compared to an ‘easily conceived’ pregnancy.

Even choosing how and when to tell people, you’re expecting can be nerve-racking. If you have friends or relations with fertility issues, you might feel like you’re leaving them behind.

Step 9B: Choosing to move on

Not all infertile couple will succeed. If eventually, you’re unable to get pregnant or have to stop treatment due to financial reasons, it can be disappointing.

If your heartbreak is overwhelming, you should seek emotional support from a trusted family member or friend, counsellor, or self-help support group.

What other steps do you feel couples should take when faced with fertility issues and what advice would you give to the ones trying to move on when treatments fail?