Women who fail to achieve a successful pregnancy after 12 months of regular, unprotected intercourse should be evaluated with the diagnosis of infertility. Evaluation should be initiated after 6 months for women >35 years. If over 40 years of age, or a condition known to cause infertility is present, evaluation should not be delayed.
Evaluation of women for infertility should be timely, cost effective, and initially focused on the most common causes of infertility such as ovulatory dysfunction. If ovulatory function is normal, uterine anatomy and tubal patency should be investigated. Tests for ovarian reserve can not predict failure to conceive and therefore should not be used to deny fertility treatment. Ovarian reserve testing should not be used to predict the likelihood of spontaneous conception or menopause.
Indications for Immediate Evaluation Include
Definition of Unexplained Infertility (30% of infertile couples)
ASRM: Fertility evaluation of infertile women: a committee opinion
ACOG and ASRM Committee Opinion 781: Infertility Workup for the Women’s Health Specialist
ACOG Committee Opinion 773: The Use of Antimüllerian Hormone in Women Not Seeking Fertility Care
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