Should i see a doctor about conceiving? i am 22 years old. i had a miscarriage a year ago. since then my periods have been between 31 and 36 day cycles. my husband and i have been actively trying to conceive for going on 4 months now with no results. i ho

A : A person should see a doctor for an infertility evaluation when they meet the diagnostic criteria for infertility or they have a medical history that makes it obvious that they cannot get pregnant. The diagnostic criteria for infertility are based on age. At age 22, you meet the criteria for infertility if you have been at risk for pregnancy 12 months or more and have not conceived. I like to separate the concept of "trying" from being "at risk" for pregnancy. Many of my patients have been sexually active and not on a contraceptive method for many months but have only started "trying" for a limited number of months. I ask them to think back and calculate the total number of months that they could have gotten pregnant and have not. In your case, if that number is greater than 12, then you need to see your ob/gyn or an infertility specialist. As far as medical history factors that would justify an earlier visit, if someone has had an infection or surgery that has caused them to lose the function of both fallopian tubes, there is no need to wait before seeking help. If someone is clearly not having periods at all or very infrequently, they should seek help right away. If someone does an ovulation predictor kit at home and they are not showing a positive for approximately 3 months then they should seek help right away. These are some of the reasons to go directly to an evaluation. It is always a good idea to let your primary care giver know that you are trying to get pregnant. They can do a comprehensive review of your medical history and identify any other factors which would warrant and expedited evaluation. From you past miscarriage you know that you ovulate at least sometimes, that at least one of your tubes was working a year ago as was your partner's sperm. Probably the best thing for you to do is to get an ovulation predictor kit and document ovulation. When doing this, you should not abstain from intercourse until the kit turns positive. If you are having intercourse 2 to 3 times a week already then just continue that. If intercourse is less frequent, start having every other day intercourse when you start using the ovulation predictor kit making sure that you have intercourse before it turns positive and then the day or the day after it turns positive. Good luck!

Good: not infertile: The good news is that we know that you are not infertile, which can pose insurmountable problems for a successful pregnancy. And you have been trying only 4 months for another pregnancy. 1 or 2 misarriages are so common they are regarded as normal. A couple generally need to be trying to conceive for 12 mo before you are considered in need of an infertility workup.