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Infertility / TTC

Also called TTC · trying to conceive · fertility evaluation · semen analysis · ovulation workup

Named sources. May contain inaccuracies or be incomplete. Not medical, legal, financial, or other professional advice.

TTC means trying to conceive. A fertility evaluation asks about ovulation, sperm, the uterus and fallopian tubes, then connects the findings to care options. When trying with one's own eggs and no known concern, usually ask for evaluation after 12 months under 35 or six months at 35 and older; known concerns or age over 40 can justify asking sooner. Tests help answer particular questions, and treatment can help in selected circumstances, but neither a hormone number nor IVF guarantees a baby.

Understand what fertility evaluation can answer

TTC means trying to conceive. The useful first question is whether it is time to seek an assessment, then what the assessment needs to explain.

Follow the reproductive steps to understand the tests

A pregnancy requires more than one normal hormone number. An ovary releases an egg; sperm must fertilize it; the developing embryo must reach the uterus and implant in its lining. CDC explains that difficulty at one or several of these steps can contribute to infertility. That is why a workup considers ovulation, sperm, the uterus and fallopian tubes together. It is a search for information that changes care, rather than a competition to identify whose body is responsible. A prior pregnancy also does not prove that every step is working now.

Infertility: Frequently Asked Questions Infertility

Use the definition to ask for care that fits your circumstances

Infertility describes difficulty achieving a successful pregnancy; it does not mean pregnancy is certainly impossible. WHO distinguishes primary infertility, when no pregnancy has been achieved, from secondary infertility after a previous pregnancy. ASRM's 2023 definition also includes people who need medical intervention to achieve pregnancy, including individual and donor-assisted pathways. This matters because someone should not have to fit a two-person trying timeline to receive a relevant assessment. The history and intended conception pathway establish which questions need answering; relationship status alone should not delay care.

Infertility Definition of infertility: a committee opinion (2023)

Bring previous pregnancy losses into the medical conversation

Getting pregnant and carrying a pregnancy to delivery are related but different clinical questions. CDC notes that reproductive endocrinologists may also help with recurrent pregnancy loss, described there as two or more spontaneous miscarriages. Repeated losses deserve a clinician's assessment rather than automatically restarting the usual waiting clock for difficulty conceiving. Bring the dates, gestational stages and available records. A clinician can explain whether a fertility evaluation, a pregnancy-loss evaluation or both are appropriate; this article cannot diagnose the cause from a history of loss.

Infertility: Frequently Asked Questions

Know when to start the conversation

Ask for evaluation after the usual age-and-duration threshold

For someone trying without a known fertility concern, ASRM uses 12 months when the person attempting pregnancy with their own eggs is under 35 and six months at 35 or older. These thresholds guide when to begin an assessment. They do not say that pregnancy before the deadline is guaranteed or that pregnancy after it is impossible. Age informs planning because reproductive potential changes with time, but a birthday is not an individual diagnosis. Write down the duration honestly, including pauses or uncertainty, so the clinician can apply the guidance to the actual history.

Consider two invented referral notes. One says only 'We have been trying for a while.' The other gives the person's age, an approximate start date, any pauses and a known concern they want to discuss. The second supplies information a clinician can use to decide how the general timing guidance applies. It does not require the person to know which test or treatment will follow.

If there is uncertainty about the timeline, mark it rather than invent precision. If a known concern is present, include it instead of waiting solely to complete a calendar interval. The resulting appointment may clarify what to assess, which existing records are useful and who coordinates the next step. It cannot promise an explanation from one test or a pregnancy from evaluation. This example makes the threshold a route into assessment, rather than a verdict about an individual outcome.

Definition of infertility: a committee opinion (2023)Infertility: Frequently Asked Questions

Discuss known concerns before waiting for an anniversary

ASRM's evaluation opinion supports assessment without delay when a history suggests impaired fertility. Missing or irregular periods, suspected tubal or uterine disease, endometriosis, a known sperm problem and previous treatments that can damage reproductive function are examples. Over 40, a more immediate evaluation may be warranted. A referral request can name the concern directly: 'My periods have stopped' or 'I had chemotherapy and want to understand fertility.' The clinician decides the appropriate tests; the useful action is bringing the concern forward, rather than waiting simply because twelve months have not passed.

Fertility evaluation of infertile women: a committee opinion (2021)

Coordinate assessment of every relevant reproductive contributor

When a male partner provides sperm, evaluation should run alongside the assessment of the person who may carry the pregnancy. AUA/ASRM guidance makes reproductive history and semen analysis early parts of that workup. This can prevent months of testing one person before recognizing a contributor in the other, and more than one factor can coexist. For donor-assisted or individual care, ask what evaluation fits that pathway. 'Both partners' describes one common arrangement; it is not a universal entry requirement or a reason to deny assessment.

Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I (2020)Definition of infertility: a committee opinion (2023)

Use the first visit to obtain a plan rather than a shopping list

A consultation does not obligate someone to IVF. ASRM's patient overview describes starting with histories and previous records, then deciding which tests or referrals are useful. A reproductive endocrinologist is an obstetrician-gynecologist with additional fertility training; a reproductive urologist evaluates male infertility. Some first steps can begin with an existing clinician. Ask who will coordinate the results, what each test would change and when the findings will be explained together. A clear first appointment should reduce uncertainty about the process even when it cannot settle the outcome.

Infertility: an Overview (booklet)Basic Infertility Evaluation

Understand the named first tests

Use cycle history to ask whether ovulation is occurring

Ovulation means releasing an egg from an ovary. Regular periods often supply useful evidence, while long gaps or absent periods can point toward an ovulation problem that needs an explanation. ASRM says that regular 21–35-day cycles usually do not require extra confirmation, with exceptions such as signs of excess androgen activity. If confirmation is needed, a progesterone blood test can show recent ovulation when timed about a week before the expected next period. A fixed 'day 21' test does not fit every cycle. One measurement also cannot grade the entire quality of the cycle.

Fertility evaluation of infertile women: a committee opinion (2021)

Read semen analysis as several measurements with context

Semen analysis measures features of a collected sample, including sperm concentration, movement and shape. AUA/ASRM explains that a value above or below a reference limit cannot, by itself, classify someone as fertile or infertile. Samples also vary, so an abnormal first result commonly needs repeat testing and a reproductive-urology review. Ask what was measured, whether collection conditions affected interpretation and what a repeat would clarify. The combined pattern and medical history matter more than treating one flagged number as a verdict; a normal sample does not answer every fertility question either.

Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I (2020)Basic Infertility Evaluation

Ask which structural question an imaging test answers

HSG means hysterosalpingography: dye is introduced through the cervix and X-ray imaging follows it through the uterus and fallopian tubes. It can help assess the uterine cavity and whether the tubes appear open. NICHD also describes ultrasound and saline-based imaging for looking inside the uterus. These tests answer different questions, so one result need not replace every other assessment. Ask what the clinician is looking for and what an abnormal finding would lead to. 'The tubes appear open' does not prove every reproductive process is normal.

How is infertility diagnosed?

Use AMH and follicle counts to plan ovarian stimulation

Ovarian reserve refers mainly to the remaining egg supply; egg quantity and egg quality are different ideas. AMH, or anti-Müllerian hormone, is a hormone associated with small growing follicles. Antral follicle count is an ultrasound count of visible small follicles. ASRM finds these measures useful for anticipating response to medicines that stimulate the ovaries and expected egg yield. They cannot independently predict unassisted conception or guarantee a live birth. A very low AMH alone should not be used to deny IVF. Ask what decision the result changes, alongside age, diagnosis and any previous treatment response. ASRM discourages general reserve screening when fertility is untested.

Testing and interpreting measures of ovarian reserve: a committee opinion (2020)

Let a specific finding guide further testing or surgery

A larger test panel is not automatically a more useful evaluation. ESHRE's unexplained-infertility guideline identifies many additional tests with limited evidence and discourages routine testing that does not establish a useful cause. Surgery also needs a defined target and an expected benefit. ASRM does not recommend routine laparoscopy for infertility without a suspected pelvic problem or another indication. If a procedure is proposed, ask what it addresses, what less invasive alternatives exist and how recovery or delay affects the wider plan. Finding a difference in anatomy is the start of interpretation, not a treatment instruction.

Unexplained Infertility guideline (2023)Fertility evaluation of infertile women: a committee opinion (2021)How is infertility diagnosed?

Connect treatment options to the findings

Match an ovulation medicine to a diagnosed ovulation problem

PCOS, or polycystic ovary syndrome, is a clinically assessed hormonal and metabolic condition that can disrupt ovulation. Anovulation means eggs are not being released; irregular cycles can have other causes too. Teede and colleagues' 2023 international guideline recommends letrozole as first-line medicine for infertility caused by anovulation in PCOS when other infertility factors are absent. That qualification matters: sperm or tubal findings may change care. Letrozole remains off-label for this use in many countries and requires clinician assessment, including excluding an existing pregnancy. The recommendation explains a pathway; it is not a prescription for every person with PCOS.

Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome

Read a treatment trial's actual population and outcome

Legro and colleagues randomly assigned 750 women with PCOS to letrozole or clomiphene for up to five cycles. Cumulative live birth occurred in 103 of 374 women receiving letrozole, about 28%, compared with 72 of 376, about 19%, receiving clomiphene. The difference was roughly eight additional live births per 100 participants in this selected trial population. It was not a chance per monthly cycle and did not establish a guarantee for an individual. NIH's explanation makes the practical point clear: knowing the cause of infertility can identify a treatment with better evidence for that cause.

Letrozole versus clomiphene for infertility in the polycystic ovary syndrome New treatment increases pregnancy rate for women with infertility disorder

Understand what IUI changes and what it still relies on

Intrauterine insemination, or IUI, places prepared sperm directly into the uterus. Fertilization still has to occur inside the body, so its usefulness depends on the relevant ovulation, sperm and tubal circumstances. HFEA explains that it is a different procedure from IVF, with different suitability and burdens; it should not be sold simply as a cheaper version of the same treatment. It may be combined with ovarian stimulation in selected circumstances. Ask why IUI fits the findings, what monitoring is needed and what would lead the team to reconsider it.

Intrauterine insemination (IUI)Diagnosis and treatment of infertility in men: AUA/ASRM guideline part II

Follow the stages of IVF before interpreting its promise

In vitro fertilization, or IVF, involves collecting eggs and fertilizing them in a laboratory; a resulting embryo may then be transferred to the uterus. HFEA explains the separate stages because treatment can stop before transfer, and transfer does not ensure implantation, pregnancy or live birth. Medicines, scans, egg collection and possible later frozen transfers also create distinct burdens and costs. Ask which stages the estimate covers and what could alter or cancel the plan. IVF can bypass some problems and offer another route to pregnancy, but the name of the procedure does not settle the outcome. Discuss safety as well as success: transferring more embryos can increase multiple-pregnancy risk, and single-embryo-transfer research led by Van Voorhis helps explain why a safer outcome matters.

In vitro fertilisation (IVF)2019 Award for Achievement: Bradley Van Voorhis, MD

Make success rates understandable

Choose the outcome and denominator before comparing percentages

A live-birth rate is different from a positive pregnancy-test rate. Its denominator is the group of attempts or people being counted: started cycles, retrievals and transfers answer different questions. CDC's technical notes distinguish these measures and distinguish own-egg from donor-egg results. A per-transfer rate leaves out attempts that never reached transfer. Cumulative reporting can combine outcomes from linked transfers after a retrieval within a defined reporting window. Before comparing clinics, ask for the outcome, denominator, age group, egg source and timeframe. A larger percentage may describe a narrower group rather than better overall prospects.

NASS Technical Notes

Use comparable group data to ask a better personal question

Imagine a hypothetical report with 100 started cycles, 80 transfers and 32 live births. The same results would be 32% per started cycle and 40% per transfer. This illustration is arithmetic, not a national or clinic statistic. CDC provides official clinic data and an IVF estimator, but a group estimate still needs a clinician's explanation of how the patient and proposed treatment resemble that group. A successful online story can offer support; it cannot replace comparable data. Ask why the estimate applies and which important uncertainties it leaves out.

NASS Technical Notes ART Success Rates

Understand where reasonable care choices differ

Ask what unexplained infertility means after the workup

Unexplained infertility is a diagnosis of exclusion: the standard evaluation has not identified a cause. ESHRE emphasizes that this category depends on completing the appropriate basic assessment. It does not prove every biological process is normal, and it does not mean the difficulty is imagined or that care has ended. It also does not make every extra test useful. Ask which questions have been answered and what remains unknown. That distinction lets the discussion move toward options and their evidence without turning uncertainty into an unlimited search for a hidden diagnosis.

Unexplained Infertility guideline (2023)

Agree on a treatment sequence and a point for reassessment

For unexplained infertility, ESHRE's 2023 guideline recommends stimulated IUI as a first-line treatment and uses prognosis to decide when to begin. NICE's 2026 England-focused guidance instead describes trying for a total of two years before treatment in its specified pathway. That is distinct from the earlier evaluation: tests and consultation can begin before active treatment. The differences concern prognosis, treatment timing and care systems, not whether the difficulty is real. Ask which current local guidance applies, how age and previous results affect waiting, and what would prompt reassessment rather than treating either timeline as universal.

Unexplained Infertility guideline (2023)Unexplained fertility problems in people trying to conceive through unprotected vaginal sexual intercourse

Compare guideline approaches with their dates and populations

Treatment recommendations can differ over stimulation medicines as well as when to use IVF. NICE's 2026 pathway includes considering up to four gonadotropin-stimulated IUI cycles or offering IVF after discussion; ESHRE stresses low-dose regimens and monitoring to reduce multiple pregnancy and ovarian hyperstimulation syndrome, an excessive ovarian response. Historical ASRM guidance favored oral-agent IUI and discouraged gonadotropin-IUI, but its page lists a March 2024 expiration. These differences need a current clinician's interpretation. Ask why this regimen fits, what safeguards are used and when it will be reviewed; this article does not select medicines or doses.

Unexplained fertility problems in people trying to conceive through unprotected vaginal sexual intercourse Unexplained Infertility guideline (2023)Evidence-based treatments for couples with unexplained infertility: a guideline (2020)

Ask whether an optional extra improves the outcome that matters

Treatment add-ons are extra tests or procedures offered alongside standard care. HFEA rates evidence by outcome and sometimes by patient group; lack of adequate evidence is different from trials showing no benefit. An improvement in a laboratory measure or a per-transfer statistic may not mean more live births across treatment. Ask which comparable patients were studied, the absolute benefit, possible harms and extra cost. A justified use for one condition does not make an add-on necessary for everyone. Forum disagreements about embryo testing prompted this question; the regulator's evidence, not the discussion's popularity, supports it.

Treatment add-ons with limited evidence

Ask which patients benefit from embryo chromosome screening

PGT-A tests a sample of embryo cells for an abnormal chromosome count before a possible transfer. The unresolved question is whether selection improves the total chance of a live birth for the particular patient, not simply whether a selected embryo has a favorable transfer outcome. ASRM's 2024 opinion says a routine benefit for all IVF patients has not been demonstrated and describes limitations in studies of selected groups. Ask about cumulative live birth, miscarriage, inconclusive results, costs and what happens to embryos with uncertain findings. Screening evidence should be discussed separately from testing for a known inherited disorder.

The use of preimplantation genetic testing for aneuploidy: a committee opinion (2024)

Balance health improvements with the cost of delaying care

Weight can affect ovulation, pregnancy health and the safety of fertility procedures, but improving a health measure does not automatically improve every fertility outcome. ASRM's obesity opinion reports that weight-loss interventions may improve ovulation in anovulatory women, while trials have not consistently shown better live birth after treatment in ovulatory women. The field must balance possible benefits, procedural safety and the reproductive cost of delay, especially with advancing age. Ask which outcome a proposed delay is intended to improve and what evidence supports it for this situation. This is a care discussion, not a blame assignment or a self-directed weight target.

Obesity and reproduction: a committee opinion (2021)

Keep the workup useful and manageable

Keep one concise history and the existing reports

Bring trying duration, cycle patterns, previous pregnancies and losses, relevant surgery, infections, cancer treatment and current medicines or supplements. ASRM's patient overview explains that reviewing existing records can reduce waste from repeated evaluation. Record uncertain dates as uncertain. Keep the original reports beside the clinician's interpretation, rather than only a remembered label such as 'low hormones.' This gives the next clinician something concrete to review and makes it easier to explain why a repeat test is needed.

Infertility: an Overview (booklet)How is infertility diagnosed?

Keep the clinical question beside each result

A useful record has three parts: what was being investigated, what the test found and what happens next. For example, a structural image and a hormone test do not answer the same question. Lobo's public evaluation teaching connects the different tests before discussing a treatment plan. Use that approach when results arrive separately: ask how they fit together. Write down who will explain the combined findings and the follow-up date. This is a way to organize clinical conversations, not a method for diagnosing yourself from reference ranges.

Basic Infertility Evaluation

Discuss medicines and health support without assigning blame

WHO recommends practical support such as tobacco cessation, activity and a healthy diet alongside fertility care. These steps do not identify the cause of one unsuccessful cycle or guarantee conception. Medication review also matters for sperm: AUA/ASRM explains that external testosterone can suppress sperm production, even when used for another health goal. Bring prescribed medicines, hormones and supplements to the clinician rather than changing them on your own. Ask what support is appropriate now and which changes have evidence for the outcome being discussed.

WHO issues first global guideline on infertility Diagnosis and treatment of infertility in men: AUA/ASRM guideline part II

Include emotional support as part of care

Waiting, tests and uncertain outcomes can affect daily life, work and finances. WHO's guideline release calls for ongoing psychosocial support, and Cardiff researchers Boivin and Gameiro develop tools and guidance addressing fertility-related well-being and care needs. Counseling is support for someone living through a difficult process; needing it is not evidence that distress caused the infertility. Ask about counseling, peer support or social-work help and whether it is independent of treatment sales. Support can be useful whether care continues, changes or pauses.

WHO issues first global guideline on infertility Professor Jacky Boivin Dr Sofia Gameiro

Keep total burden and the review point in the decision

A treatment decision includes appointments, monitoring, medicines, procedures, travel, work disruption and possible further attempts. WHO recognizes financial barriers, while Gameiro's research addresses how people experience treatment burden and decisions about continuation. Ask for a written estimate of what the proposed step includes and excludes, and verify local coverage directly. NICE's England-focused guidance is not US insurance entitlement; its 2026 NG257 replaced CG156, but detailed access rules need current local confirmation. A pause or second opinion can be discussed without treating it as a failure of commitment.

WHO issues first global guideline on infertility Dr Sofia Gameiro In vitro fertilisation (IVF)Fertility problems: assessment and treatment (NG257)

Check a fertility claim against the evidence

These short judgments connect to the fuller explanations above. A verdict applies to the wording of the claim, not to a person's prognosis.

Use the usual clocks with their exceptions

Claim: 'Evaluation usually starts at 12 months under 35 or six months at 35 and older.' Verdict: established. ASRM provides these thresholds when no earlier concern is known. Known risks can justify earlier assessment; the clocks do not predict an individual outcome.

Definition of infertility: a committee opinion (2023)Fertility evaluation of infertile women: a committee opinion (2021)

Include sperm assessment when sperm is part of the plan

Claim: 'A workup can routinely skip semen analysis.' Verdict: not. AUA/ASRM includes semen assessment early when applicable. Individual and donor-assisted pathways are adapted to their circumstances.

Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I (2020)

Use AMH for a defined planning question

Claim: 'An online AMH kit tells me whether I can conceive.' Verdict: not. AMH can inform expected ovarian response; it cannot independently answer natural-conception potential. Keep the report for clinical interpretation.

Testing and interpreting measures of ovarian reserve: a committee opinion (2020)

Ask about live birth with every IVF estimate

Claim: 'IVF guarantees a baby.' Verdict: not. IVF has stages that may not reach transfer, pregnancy or live birth. An estimate needs its outcome and denominator.

In vitro fertilisation (IVF)NASS Technical Notes

Connect PCOS care to the demonstrated ovulation problem

Claim: 'A clinician can evaluate PCOS as an ovulatory contributor.' Verdict: established. The international guideline identifies a clinical pathway, while keeping other infertility contributors in view.

Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome

Seek help using the history rather than folklore

Claim: 'People should wait many years before asking for evaluation.' Verdict: talk. Professional evaluation thresholds and earlier-risk exceptions provide a better starting point. A conversation does not settle the prognosis.

Definition of infertility: a committee opinion (2023)

Use an unexplained result to discuss the remaining options

Claim: 'Unexplained infertility means nothing can be done.' Verdict: not. It describes what the standard evaluation has not explained. ESHRE provides further care options while acknowledging substantial uncertainty.

Unexplained Infertility guideline (2023)

Use this understanding with qualified care

Bring persistent difficulty and known disease to a clinician

This is a reading companion, not a diagnosis, not a fertility-clinic visit, and not an intimacy or dating guide. Persistent inability to conceive, repeated miscarriage, or known reproductive disease belongs with a qualified clinician. This page does not promise a pregnancy. Named sources. Honest paraphrase of the finding. Not medical, legal, or financial advice. The sources explain populations and clinical pathways; a clinician still needs the individual's history, examination and results before selecting tests or treatment.

Infertility: Frequently Asked Questions Definition of infertility: a committee opinion (2023)

010

Leave the next conversation with a clear question

Arrange an assessment when the history calls for one

The next move is to contact an appropriate clinician when the usual age-and-duration threshold has been reached, or sooner for a known concern. Give your age, how long pregnancy has been attempted, the intended conception pathway and any concern that may justify earlier assessment. If sperm assessment is relevant, ask how it will be coordinated. The goal of this first contact is an evaluation plan with named questions and a follow-up point, rather than choosing a treatment from an online success story.

Definition of infertility: a committee opinion (2023)Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I (2020)

Prepare a short history before the visit

Try-step one: gather existing reproductive records and make a brief timeline of attempts, cycles, previous pregnancies or losses, relevant operations or treatments and medicines. ASRM's overview explains why access to previous records can reduce unnecessary repetition. Add the question you most need answered, such as whether earlier assessment is appropriate or why a particular test is proposed. You do not need a perfectly documented calendar or a purchased hormone panel before asking for help.

Infertility: an Overview (booklet)

Ask for the result-to-decision link

Write down: 'What does this test answer, and what decision will change when we have the result?' For a treatment discussion, add 'What live-birth outcome, risks, total burden and review point apply to people with similar findings?' Lobo's evaluation explanation and WHO's care framework both connect assessment to a plan. Keep the answers with the reports so the next appointment builds on what has already been learned.

Basic Infertility Evaluation WHO issues first global guideline on infertility

References for this topic

Sources and context

Infertility: Frequently Asked Questions ↗
id
infertility-ttc--cdc-infertility — Infertility: Frequently Asked Questions
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official
accessed at
2026-10-01
supports
Public-health definition, reproductive steps, age, recurrent pregnancy loss and major contributors.
limitations
Public definitions explicitly do not determine access to individual services.
original id
cdc-infertility
Infertility ↗
id
infertility-ttc--who-infertility — Infertility
kind
official
accessed at
2026-10-01
supports
Primary/secondary infertility; male/female contributors; social and access burdens.
limitations
Global overview; prevalence and risk factors do not identify a personal cause.
original id
who-infertility
Definition of infertility: a committee opinion (2023) ↗
id
infertility-ttc--asrm-definition — Definition of infertility: a committee opinion (2023)
kind
guideline
accessed at
2026-10-01
supports
Inclusive definition; usual 12/6-month evaluation clocks; circumstances requiring intervention; no delay solely by relationship status.
limitations
Definition and professional opinion, not insurance entitlement.
original id
asrm-definition
Fertility evaluation of infertile women: a committee opinion (2021) ↗
id
infertility-ttc--asrm-evaluation — Fertility evaluation of infertile women: a committee opinion (2021)
kind
guideline
accessed at
2026-10-01
supports
Earlier evaluation indications; ovulation assessment; test selection; HSG limitations; targeted surgery.
limitations
US specialist guidance, not an individualized workup.
original id
asrm-evaluation
Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I (2020) ↗
id
infertility-ttc--male-evaluation — Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I (2020)
kind
guideline
accessed at
2026-10-01
supports
Parallel assessment, variable semen measurements, repeat abnormal samples, specialist review.
limitations
Based on the 2020 text; the 2024 amendment was unavailable for review. No amended genetic thresholds are used.
original id
male-evaluation
Infertility: an Overview (booklet) ↗
id
infertility-ttc--asrm-overview — Infertility: an Overview (booklet)
kind
professional
accessed at
2026-10-01
supports
Types of specialists, records, histories, reducing repeated tests.
limitations
Patient booklet includes older practices; no unsupported success promise or obsolete reserve-test advice carried over.
original id
asrm-overview
Basic Infertility Evaluation ↗
id
infertility-ttc--lobo-evaluation — Basic Infertility Evaluation
kind
professional
accessed at
2026-10-01
supports
Roger Lobo’s public teaching explains the core evaluation and specialist referrals.
limitations
Based on the transcript, not video review. Its egg-quality shorthand is qualified here using ASRM’s more precise ovarian-reserve opinion.
original id
lobo-evaluation
How is infertility diagnosed? ↗
id
infertility-ttc--nichd-diagnosis — How is infertility diagnosed?
kind
official
accessed at
2026-10-01
supports
History, ultrasound, HSG procedure and different structural tests.
limitations
General overview contains fixed-day progesterone language; ASRM individualized timing governs this article.
original id
nichd-diagnosis
Testing and interpreting measures of ovarian reserve: a committee opinion (2020) ↗
id
infertility-ttc--asrm-reserve — Testing and interpreting measures of ovarian reserve: a committee opinion (2020)
kind
guideline
accessed at
2026-10-01
supports
AMH/AFC predict stimulation response better than unassisted pregnancy; low values alone should not deny IVF.
limitations
Older committee opinion; egg quantity and egg quality are distinct. Relevant sections, rather than a new clinical assessment, support this explanation.
original id
asrm-reserve
Unexplained Infertility guideline (2023) ↗
id
infertility-ttc--eshre-ui — Unexplained Infertility guideline (2023)
kind
guideline
accessed at
2026-10-01
supports
Diagnosis of exclusion; limited evidence for extras; stimulated IUI as first-line, individualized IVF, monitored low-dose gonadotropins.
limitations
Relevant recommendations from the full European guideline; much of its evidence is low quality.
original id
eshre-ui
Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome ↗
id
infertility-ttc--pcos-guideline — Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome
kind
guideline
accessed at
2026-10-01
supports
Teede and colleagues: letrozole first-line for anovulatory PCOS infertility without other factors; off-label status and pregnancy exclusion.
limitations
Official 26-page guideline summary, not the complete Monash guideline. The recommendation applies to the specified population.
original id
pcos-guideline
Letrozole versus clomiphene for infertility in the polycystic ovary syndrome ↗
id
infertility-ttc--legro-trial — Letrozole versus clomiphene for infertility in the polycystic ovary syndrome
kind
study
accessed at
2026-10-01
supports
Randomized 750-woman trial, up to five cycles; cumulative live birth 27.5% versus 19.1%.
limitations
Primary abstract; selected PCOS population, not all infertility or per-cycle probabilities.
original id
legro-trial
New treatment increases pregnancy rate for women with infertility disorder ↗
id
infertility-ttc--nih-pcos — New treatment increases pregnancy rate for women with infertility disorder
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official
accessed at
2026-10-01
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NIH explanation of the 2014 trial, eligible PCOS population and live-birth outcome.
limitations
Historical institutional explanation, not updated prescribing guidance.
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nih-pcos
Intrauterine insemination (IUI) ↗
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infertility-ttc--hfea-iui — Intrauterine insemination (IUI)
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official
accessed at
2026-10-01
supports
Prepared sperm placed in uterus; IUI and IVF differ in procedure and suitability.
limitations
The source retains legacy NICE wording; only its procedure explanation is used, not funding or referral rules.
original id
hfea-iui
Diagnosis and treatment of infertility in men: AUA/ASRM guideline part II ↗
id
infertility-ttc--male-treatment — Diagnosis and treatment of infertility in men: AUA/ASRM guideline part II
kind
guideline
accessed at
2026-10-01
supports
External testosterone can suppress sperm production; supplements have uncertain value; IUI definition.
limitations
Older guideline text; clinician-directed treatment; no doses or protocols reproduced.
original id
male-treatment
In vitro fertilisation (IVF) ↗
id
infertility-ttc--hfea-ivf — In vitro fertilisation (IVF)
kind
official
accessed at
2026-10-01
supports
IVF stages, laboratory fertilization, transfer and treatment risks.
limitations
UK regulator education; UK funding rules not generalized.
original id
hfea-ivf
2019 Award for Achievement: Bradley Van Voorhis, MD ↗
id
infertility-ttc--panel-van-voorhis — 2019 Award for Achievement: Bradley Van Voorhis, MD
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professional
accessed at
2026-10-01
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MD; University of Iowa reproductive endocrinologist and IVF safety researcher. Single embryo transfer can reduce multiple-birth burden; outcome literacy includes safety as well as pregnancy. University's public feature explains his single-embryo-transfer work and why IVF safety matters.
limitations
2020 feature verifies contribution; its administrative title is not claimed current.
original id
panel-van-voorhis
NASS Technical Notes ↗
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infertility-ttc--cdc-art-notes — NASS Technical Notes
kind
official
accessed at
2026-10-01
supports
Cycle-, retrieval- and transfer-based rates; own/donor eggs; cumulative versus noncumulative reporting.
limitations
Surveillance definitions; clinic groups and reporting lag limit individual prediction.
original id
cdc-art-notes
ART Success Rates ↗
id
infertility-ttc--cdc-art-rates — ART Success Rates
kind
official
accessed at
2026-10-01
supports
Official clinic-data access and IVF success estimator; estimates tied to patient characteristics.
limitations
Data-access landing page, not a review of individual clinics or current national numerical rates.
original id
cdc-art-rates
Unexplained fertility problems in people trying to conceive through unprotected vaginal sexual intercourse ↗
id
infertility-ttc--nice-ui — Unexplained fertility problems in people trying to conceive through unprotected vaginal sexual intercourse
kind
guideline
accessed at
2026-10-01
supports
Recommendations 1.38.1–1.38.3: total two-year trying period before treatment; no standalone stimulation; consider up to four gonadotropin-stimulated IUI cycles or offer IVF after discussion.
limitations
Based on the official chapter, not the full guideline or local commissioning criteria.
original id
nice-ui
Evidence-based treatments for couples with unexplained infertility: a guideline (2020) ↗
id
infertility-ttc--asrm-ui-historical — Evidence-based treatments for couples with unexplained infertility: a guideline (2020)
kind
guideline
accessed at
2026-10-01
supports
Historical US comparison: oral-agent IUI before IVF; cautions about gonadotropin IUI and multiple pregnancy.
limitations
The source lists a March 2024 expiration. Used only for a labeled historical comparison, not a current U.S. treatment algorithm.
original id
asrm-ui-historical
Treatment add-ons with limited evidence ↗
id
infertility-ttc--hfea-addons — Treatment add-ons with limited evidence
kind
official
accessed at
2026-10-01
supports
Optional extras; outcome/population-specific ratings; insufficient evidence differs from evidence of no benefit; page reviewed September 28, 2026.
limitations
UK regulator ratings; individual indications and safety require discussion; no universal ban inferred.
original id
hfea-addons
The use of preimplantation genetic testing for aneuploidy: a committee opinion (2024) ↗
id
infertility-ttc--asrm-pgta — The use of preimplantation genetic testing for aneuploidy: a committee opinion (2024)
kind
guideline
accessed at
2026-10-01
supports
Routine PGT-A benefit for all IVF patients not demonstrated; trial populations and denominators matter; miscarriage benefit uncertain.
limitations
Subgroup benefit and values remain individual counseling questions; chromosome screening is not all genetic testing.
original id
asrm-pgta
Obesity and reproduction: a committee opinion (2021) ↗
id
infertility-ttc--asrm-weight — Obesity and reproduction: a committee opinion (2021)
kind
guideline
accessed at
2026-10-01
supports
Weight-related associations, procedural safety, effects of weight-loss interventions on ovulation versus IVF/live birth and costs of delay.
limitations
Older opinion; weight is one contributor and care thresholds require individual safety assessment.
original id
asrm-weight
WHO issues first global guideline on infertility ↗
id
infertility-ttc--who-care — WHO issues first global guideline on infertility
kind
official
accessed at
2026-10-01
supports
November 2025 guideline release: progressively selected care, lifestyle support, patient preferences and psychosocial support.
limitations
Guideline release, not a review of the full WHO guideline. No specific treatment algorithm is inferred.
original id
who-care
Professor Jacky Boivin ↗
id
infertility-ttc--boivin-profile — Professor Jacky Boivin
kind
professional
accessed at
2026-10-01
supports
Official psychology role; fertility quality-of-life and coping-support work; public media role.
limitations
Role and contribution verification, not a medical treatment recommendation.
original id
boivin-profile
Dr Sofia Gameiro ↗
id
infertility-ttc--gameiro-profile — Dr Sofia Gameiro
kind
professional
accessed at
2026-10-01
supports
Official role, patient-support tools, ESHRE psychosocial guideline contribution and research on treatment burden.
limitations
Role/research page, not proof that support improves live birth.
original id
gameiro-profile
Fertility problems: assessment and treatment (NG257) ↗
id
infertility-ttc--nice-ng257 — Fertility problems: assessment and treatment (NG257)
kind
guideline
accessed at
2026-10-01
supports
Published March 31, 2026, replacing CG156. The overview and initial-assessment chapter describe one-year assessment and earlier referral at 36 or known risk. Chapter 1.38 describes two years of trying before treatment, followed by discussion of stimulated IUI or IVF.
limitations
Only the cited chapters were reviewed. England-focused pathway, not U.S. insurance entitlement or an instruction to postpone evaluation.
original id
nice-ng257
Thoughts on the New Research on IVF Add-Ons?? ↗
id
infertility-ttc--question-addons — Thoughts on the New Research on IVF Add-Ons??
kind
question_signal
accessed at
2026-10-01
supports
Discussion illustrates confusion over PGT-A, per-transfer versus cumulative live birth and regulator ratings.
limitations
Community questions only; no anecdotes, statistics or recommendations used as factual authority.
original id
question-addons
Marcelle Cedars | UCSF Profiles ↗
id
infertility-ttc--panel-cedars — Marcelle Cedars | UCSF Profiles
kind
professional
accessed at
2026-10-01
supports
MD; UCSF professor of Obstetrics, Gynecology and Reproductive Sciences. Ovarian-aging research helps distinguish age, egg supply and treatment response. Public UCSF profile links ovarian-aging research, clinical care and institutional news for patients seeking context.
limitations
An investigator profile establishes expertise; it does not supply a personal pregnancy forecast.
original id
panel-cedars
Richard Legro | College of Medicine | Penn State ↗
id
infertility-ttc--panel-legro — Richard Legro | College of Medicine | Penn State
kind
professional
accessed at
2026-10-01
supports
MD; Penn State professor and chair; reproductive endocrinology and infertility specialist. Lead author of the randomized letrozole–clomiphene PCOS trial used here. NIH publicly explains his PCOS trial and its live-birth outcome.
limitations
Selected anovulatory-PCOS trial results cannot be generalized to all TTC.
original id
panel-legro
Anuja Dokras, MD, MHCI, PhD | Penn DBEI ↗
id
infertility-ttc--panel-dokras — Anuja Dokras, MD, MHCI, PhD | Penn DBEI
kind
professional
accessed at
2026-10-01
supports
MD, MHCI, PhD; Penn professor and director of Penn PCOS Center. PCOS can require whole-health evaluation as well as an ovulation discussion. Official description of the multidisciplinary PCOS center shows reproductive, metabolic and psychological care in one pathway.
limitations
PCOS expertise does not establish that every irregular cycle or infertility problem is PCOS.
original id
panel-dokras
Dr. Schlegel Named Acting Chairman of Urology ↗
id
infertility-ttc--panel-schlegel — Dr. Schlegel Named Acting Chairman of Urology
kind
professional
accessed at
2026-10-01
supports
MD; urologist and male-infertility researcher; Weill Cornell institutional biography and AUA/ASRM guideline contributor. Male evaluation, sperm retrieval and the interface with assisted reproduction. Institutional public explanation of male-factor treatment and professional guideline work make male assessment visible.
limitations
Biography is historical; no current leadership title or personal success probability claimed.
original id
panel-schlegel
Samantha M. Pfeifer, M.D. | Patient Care ↗
id
infertility-ttc--panel-pfeifer — Samantha M. Pfeifer, M.D. | Patient Care
kind
professional
accessed at
2026-10-01
supports
MD; board-certified reproductive endocrinologist; Weill Cornell professor of clinical reproductive medicine. Uterine-anomaly classification and reproductive surgery illustrate why structural findings need specific interpretation. Official bio documents provider/patient MAC2021 educational tool and frequent professional teaching.
limitations
Surgical expertise does not imply surgery improves every infertility outcome.
original id
panel-pfeifer
Clarisa R. Gracia, MD, MSCE | Penn Medicine ↗
id
infertility-ttc--panel-gracia — Clarisa R. Gracia, MD, MSCE | Penn Medicine
kind
professional
accessed at
2026-10-01
supports
MD, MSCE; Penn reproductive endocrinologist, division chief and fertility-preservation director. Connects medical history, reproductive aging and an inclusive assessment pathway. Patient-facing profile explains fertility-preservation and reproductive-aging interests; named contributor to ASRM's 2023 definition.
limitations
Fertility-preservation decisions require individual medical risks and timing; no preservation guarantee.
original id
panel-gracia
Tommaso Falcone, MD | Cleveland Clinic ↗
id
infertility-ttc--panel-falcone — Tommaso Falcone, MD | Cleveland Clinic
kind
professional
accessed at
2026-10-01
supports
MD; reproductive endocrinology-trained Cleveland Clinic physician and professor. Structural disease and minimally invasive reproductive surgery inform questions about indications and alternatives. Official provider biography, education and public provider-video link explain his reproductive and surgical scope.
limitations
Provider biography establishes the clinical field, not treatment outcomes.
original id
panel-falcone
Catalogus professorum | Fauser B.C.J.M. ↗
id
infertility-ttc--panel-fauser — Catalogus professorum | Fauser B.C.J.M.
kind
professional
accessed at
2026-10-01
supports
MD, PhD; Utrecht professor emeritus of reproductive medicine. Ovarian-response and AMH scholarship helps separate biological measures from broad fertility predictions. Public university record documents reproductive-medicine scholarship and retirement lecture; Glasgow lists his AMH collaboration with Nelson.
limitations
Retired Utrecht appointment; the profile does not establish a present clinic role or findings from every listed paper.
original id
panel-fauser
Professor Scott Nelson | University of Glasgow ↗
id
infertility-ttc--panel-nelson — Professor Scott Nelson | University of Glasgow
kind
professional
accessed at
2026-10-01
supports
Professor; Muirhead Chair of Reproductive and Maternal Medicine, University of Glasgow. AMH biomarker research and quantitative prediction support careful measurement literacy. Public faculty page lists fertility research and AMH interpretation papers, giving a route to specialist evidence.
limitations
Publication listing verifies contribution; it does not mean every listed paper was read.
original id
panel-nelson
Helena Teede | Monash University ↗
id
infertility-ttc--panel-teede — Helena Teede | Monash University
kind
professional
accessed at
2026-10-01
supports
MBBS, PhD, FRACP; Monash professor and Monash Health endocrinologist. 2023 PCOS guideline specifies the population for first-line letrozole and wider health assessment. Official biography verifies community involvement, patient resources and media education; led international PCOS guideline synthesis.
limitations
Guideline recommendations have eligibility limits; no individual prescription is offered.
original id
panel-teede
Rogerio Arnaldo Lobo, MD | Obstetrics & Gynecology ↗
id
infertility-ttc--panel-lobo — Rogerio Arnaldo Lobo, MD | Obstetrics & Gynecology
kind
professional
accessed at
2026-10-01
supports
MD; Columbia professor of Obstetrics and Gynecology and reproductive endocrinology fellowship director. Explains how ovulation, semen and uterine/tubal evaluation fit together and which specialists help. ASRM’s Basic Infertility Evaluation transcript offers patient-facing teaching.
limitations
Ovarian reserve concerns egg supply and response; this teaching should be read with ASRM’s distinction between egg quantity and quality.
original id
panel-lobo
People | Eisenberg Lab | Stanford Medicine ↗
id
infertility-ttc--panel-eisenberg — People | Eisenberg Lab | Stanford Medicine
kind
professional
accessed at
2026-10-01
supports
MD; Stanford urologic surgeon-scientist and male reproductive medicine program leader. Male fertility and general-health research supports including reproductive urology in the workup. Public lab biography and institutional care-team pages explain specialist male-infertility care.
limitations
Experimental work listed by the lab is not an endorsed add-on or established treatment.
original id
panel-eisenberg

Professional perspectives

Marcelle Cedars
MD; UCSF professor of Obstetrics, Gynecology and Reproductive Sciences
Public usefulness
Public UCSF profile links ovarian-aging research, clinical care and institutional news for patients seeking context.
Contribution
Ovarian-aging research helps distinguish age, egg supply and treatment response.
Scope and limits
An investigator profile establishes expertise; it does not supply a personal pregnancy forecast.
Reviewed
2026-10-01
Richard Legro
MD; Penn State professor and chair; reproductive endocrinology and infertility specialist
Public usefulness
NIH publicly explains his PCOS trial and its live-birth outcome.
Contribution
Lead author of the randomized letrozole–clomiphene PCOS trial used here.
Scope and limits
Selected anovulatory-PCOS trial results cannot be generalized to all TTC.
Reviewed
2026-10-01
Anuja Dokras
MD, MHCI, PhD; Penn professor and director of Penn PCOS Center
Public usefulness
Official description of the multidisciplinary PCOS center shows reproductive, metabolic and psychological care in one pathway.
Contribution
PCOS can require whole-health evaluation as well as an ovulation discussion.
Scope and limits
PCOS expertise does not establish that every irregular cycle or infertility problem is PCOS.
Reviewed
2026-10-01
Peter Schlegel
MD; urologist and male-infertility researcher; Weill Cornell institutional biography and AUA/ASRM guideline contributor
Public usefulness
Institutional public explanation of male-factor treatment and professional guideline work make male assessment visible.
Contribution
Male evaluation, sperm retrieval and the interface with assisted reproduction.
Scope and limits
Biography is historical; no current leadership title or personal success probability claimed.
Reviewed
2026-10-01
Samantha Pfeifer
MD; board-certified reproductive endocrinologist; Weill Cornell professor of clinical reproductive medicine
Public usefulness
Official bio documents provider/patient MAC2021 educational tool and frequent professional teaching.
Contribution
Uterine-anomaly classification and reproductive surgery illustrate why structural findings need specific interpretation.
Scope and limits
Surgical expertise does not imply surgery improves every infertility outcome.
Reviewed
2026-10-01
Clarisa Gracia
MD, MSCE; Penn reproductive endocrinologist, division chief and fertility-preservation director
Public usefulness
Patient-facing profile explains fertility-preservation and reproductive-aging interests; named contributor to ASRM's 2023 definition.
Contribution
Connects medical history, reproductive aging and an inclusive assessment pathway.
Scope and limits
Fertility-preservation decisions require individual medical risks and timing; no preservation guarantee.
Reviewed
2026-10-01
Tommaso Falcone
MD; reproductive endocrinology-trained Cleveland Clinic physician and professor
Public usefulness
Official provider biography, education and public provider-video link explain his reproductive and surgical scope.
Contribution
Structural disease and minimally invasive reproductive surgery inform questions about indications and alternatives.
Scope and limits
Provider biography establishes the clinical field, not treatment outcomes.
Reviewed
2026-10-01
Bradley Van Voorhis
MD; University of Iowa reproductive endocrinologist and IVF safety researcher
Public usefulness
University's public feature explains his single-embryo-transfer work and why IVF safety matters.
Contribution
Single embryo transfer can reduce multiple-birth burden; outcome literacy includes safety as well as pregnancy.
Scope and limits
2020 feature verifies contribution; its administrative title is not claimed current.
Reviewed
2026-10-01
Bart Fauser
MD, PhD; Utrecht professor emeritus of reproductive medicine
Public usefulness
Public university record documents reproductive-medicine scholarship and retirement lecture; Glasgow lists his AMH collaboration with Nelson.
Contribution
Ovarian-response and AMH scholarship helps separate biological measures from broad fertility predictions.
Scope and limits
Retired Utrecht appointment; the profile does not establish a present clinic role or findings from every listed paper.
Reviewed
2026-10-01
Scott Nelson
Professor; Muirhead Chair of Reproductive and Maternal Medicine, University of Glasgow
Public usefulness
Public faculty page lists fertility research and AMH interpretation papers, giving a route to specialist evidence.
Contribution
AMH biomarker research and quantitative prediction support careful measurement literacy.
Scope and limits
Publication listing verifies contribution; it does not mean every listed paper was read.
Reviewed
2026-10-01
Helena Teede
MBBS, PhD, FRACP; Monash professor and Monash Health endocrinologist
Public usefulness
Official biography verifies community involvement, patient resources and media education; led international PCOS guideline synthesis.
Contribution
2023 PCOS guideline specifies the population for first-line letrozole and wider health assessment.
Scope and limits
Guideline recommendations have eligibility limits; no individual prescription is offered.
Reviewed
2026-10-01
Rogerio (Roger) Lobo
MD; Columbia professor of Obstetrics and Gynecology and reproductive endocrinology fellowship director
Public usefulness
ASRM's opened Basic Infertility Evaluation transcript is a direct public teaching resource.
Contribution
Explains how ovulation, semen and uterine/tubal evaluation fit together and which specialists help.
Scope and limits
Ovarian reserve concerns egg supply and response; this teaching should be read with ASRM’s distinction between egg quantity and quality.
Reviewed
2026-10-01
Jacky Boivin
PhD; Cardiff professor and Chair in the School of Psychology
Public usefulness
Official profile identifies media commentary and tools supporting people trying to conceive, including fertility quality-of-life work.
Contribution
Psychosocial research keeps emotional burden and accessible support inside fertility care.
Scope and limits
Support is valuable for well-being; it is not a proven fertility cure.
Reviewed
2026-10-01
Sofia Gameiro
PhD in health psychology; Cardiff Reader in the School of Psychology
Public usefulness
Official profile links patient-support tools and ESHRE psychosocial-care guidance she co-developed.
Contribution
Research on treatment burden, care preferences and continuation/discontinuation informs review-point discussions.
Scope and limits
Psychological research does not determine the biological cause or prescribe a treatment sequence.
Reviewed
2026-10-01
Michael Eisenberg
MD; Stanford urologic surgeon-scientist and male reproductive medicine program leader
Public usefulness
Public lab biography and institutional care-team pages explain specialist male-infertility care.
Contribution
Male fertility and general-health research supports including reproductive urology in the workup.
Scope and limits
Experimental work listed by the lab is not an endorsed add-on or established treatment.
Reviewed
2026-10-01

Keep this topic in view

Preserved original record

The earlier public profile is preserved separately from the current article. It may contain superseded wording and is not newly checked material.

Read the full original profile

slug

infertility-ttc

name

Infertility / TTC

browse Line

Ask about evaluation after 12 months of trying, or after 6 months at 35 and older.

photo

/learn/assets/topics/infertility-ttc.jpg

photo Alt

Two adults at a kitchen table with a calendar and a water glass, talking in calm daylight

aliases

TTC
trying to conceive
fertility evaluation
semen analysis
ovulation workup

family

home

heat

mid

talk

Sources

most Discussed

true

first Line

TTC means trying to conceive; infertility is difficulty achieving a pregnancy that may need medical evaluation. Evaluation looks at timing, ovulation, sperm, the uterus and fallopian tubes, then matches treatment options to the findings.

why Line

feel Words

12 months
6 months
age 35
TTC
male factor
semen analysis
both of us
semen

common Picture

lead
Ask about evaluation after 12 months, or after 6 months at 35 and older
why
ASRM’s 2021 evaluation opinion uses 12 months of trying for people under 35 and six months at 35 or older when no earlier concern is known. Over 40, more immediate evaluation may be warranted. Missing or irregular periods, suspected reproductive disease, previous treatment that could impair fertility or a known sperm problem can justify earlier assessment. These are points for starting a workup, not predictions that pregnancy is impossible. Bring the duration, cycle history and relevant medical records to the first appointment.
lead
Bring both partners into the first workup
why
When a male partner contributes sperm, ASRM recommends evaluating that partner in parallel with the person who may carry the pregnancy. Semen analysis describes features such as sperm number and movement; it is part of assessment, not a simple fertile-or-infertile score. Reviewing both histories early can change which tests or treatment make sense. People using donor sperm or seeking care individually need a pathway suited to their circumstances, so “both partners” is not a universal requirement for receiving care.
lead
Ask for the named first tests rather than a shopping panel
why
ASRM organizes initial assessment around ovulation, semen when applicable, and the structure and openness of the reproductive tract. HSG means hysterosalpingography, an imaging test used to assess the uterine cavity and whether fallopian tubes are open. AMH means anti-Müllerian hormone; it can help estimate ovarian response during treatment but does not independently answer whether natural conception is possible. Ask which question each proposed test answers and how its result would change the next step, rather than equating a larger panel with a better evaluation.
lead
Treat IVF and medicines as options after a diagnosis, not as a promise
why
Treatment depends on the cause, age, previous results and preferences. Intrauterine insemination, or IUI, places prepared sperm in the uterus; IVF fertilizes eggs in a laboratory and may lead to embryo transfer. Some ovulation problems instead have a medicine-based pathway. The international PCOS guideline recommends letrozole for a specific group with anovulatory infertility, not for every person trying to conceive. Ask about expected live birth, treatment burden, monitoring and the point for reassessing the plan; a treatment name alone does not establish the likely outcome.

situation Quick Answers

- label
  Usual timing
  value
  ASRM uses 12 months under 35 and six months at 35 or older when no earlier concern is known.
- label
  Ask sooner
  value
  Over 40, missing or irregular periods, known reproductive disease or prior fertility-affecting treatment can warrant earlier evaluation.
- label
  Parallel assessment
  value
  When a male partner contributes sperm, include semen assessment and both histories at the start.
- label
  Fit the pathway
  value
  Individual and donor-assisted care need assessment matched to the conception plan.
- label
  First questions
  value
  Does ovulation occur, is sperm assessment needed, and are uterine or tubal factors involved?
- label
  AMH
  value
  It helps estimate response to stimulation; it is not a yes-or-no test of natural conception.
- label
  Choose from the findings
  value
  Ovulation medicines, IUI and IVF address different situations.
- label
  Compare outcomes
  value
  Ask about live birth, the denominator behind a success rate, burden, monitoring and when the plan will be reassessed.

picture Lead

Ask about evaluation after 12 months, or after 6 months at 35 and older

watch For

what People Say

Use the evaluation timing that fits the history. ASRM’s evaluation opinion uses age and duration of trying to decide when a workup should begin, with earlier assessment for known risks. The common 12- and six-month clocks apply to people without an earlier indication. A prolonged wait is not required to discuss absent periods, prior cancer treatment or a suspected reproductive condition.
Include sperm assessment when it is part of the conception plan. WHO and ASRM describe infertility involving male factors, female factors or both. Parallel assessment avoids finishing one person’s entire workup before considering the other. The relevant question is whose reproductive contribution needs evaluating; donor-assisted and individual care should be organized around that actual plan.
Ask what each first test is intended to reveal. The usual evaluation considers whether ovulation occurs, whether sperm assessment is needed, and whether uterine or tubal factors could be involved. ASRM selects tests from the history rather than using one unlimited screening panel. Knowing the clinical question helps explain why a particular test is useful now and another can wait.
Discuss age as useful information for planning. ASRM identifies age as an important predictor of fertility and a reason evaluation may begin earlier. It does not make one birthday a diagnosis or determine an individual outcome. Bring age together with trying time, previous pregnancies, medical history and treatment goals so the discussion becomes a plan with a review point.
Connect a PCOS diagnosis to the specific ovulation problem. Polycystic ovary syndrome can affect ovulation, but the diagnosis requires a clinical assessment and does not explain every fertility difficulty. The international guideline distinguishes infertility caused by anovulation from other contributors. Treatment selection therefore follows the diagnosis and other test results, rather than treating the label PCOS as a complete workup.
Ask which outcome an IVF estimate describes. IVF involves laboratory fertilization and a possible embryo transfer, with several steps at which a cycle can stop. CDC reports different outcome measures, including live birth, and distinguishes patient and egg-source groups. A percentage per transfer is not the same as a percentage per started treatment cycle. Read the measure before comparing offers.

disputed Notes

Use ovarian reserve testing for a defined planning question. AMH and ultrasound antral-follicle counts help estimate how ovaries may respond to stimulation. ASRM warns against using them as standalone tests of unassisted pregnancy potential. A low result can inform a conversation about treatment response without establishing that pregnancy cannot happen, and a high result does not guarantee a live birth.
Agree on what would trigger the next treatment step. WHO’s guideline describes moving through options using the test findings and patient preferences. After evaluation, timing can reflect age, diagnosis, prior attempts, cost and treatment burden. Ask how long a proposed step will be tried and what result would lead to reassessment, rather than accepting a sequence with no stopping or review point.
Make health support practical and free of blame. WHO includes tobacco cessation, activity and other health support in fertility care, while also recognizing financial and psychosocial barriers. These supports can accompany evaluation; they do not identify the cause of one person’s infertility. A useful plan names the achievable change and available help instead of attributing every unsuccessful cycle to behavior.
Ask what unexplained infertility means in this workup. The term means the standard evaluation has not identified a cause, not that every biological process has been measured or that the difficulty is imagined. ASRM and NICE describe further care choices after assessment. Ask which causes have been assessed, what remains uncertain and how that uncertainty affects the next treatment decision.

talk Notes

Use clinical timing to begin a conversation. CDC and ASRM provide a starting point for seeking evaluation instead of relying on a story about how long someone else waited. The workup may identify a treatable contributor or clarify the options. Reaching an evaluation threshold is permission to ask for help, not proof of a particular diagnosis or outcome.
Treat fertility as a shared assessment when both partners contribute. WHO describes male and female causes, so testing only one contributor can miss useful information. Semen analysis belongs early when applicable, alongside the other history and tests. This is a practical way to organize care, not a way to assign blame to whichever result first falls outside a reference range.
Bring a home hormone result into the complete history. A test kit produces a measurement under particular collection and laboratory conditions. ASRM’s ovarian-reserve opinion explains why that measurement cannot supply a yes-or-no conception prediction. Keep the report and ask what it changes in the evaluation, rather than buying repeated tests to obtain a preferred number.
Read IVF stories alongside comparable outcome data. A successful personal account shows one experience and cannot estimate another person’s chance. CDC reports distinguish age groups and egg sources because those features affect how results should be read. Compare like outcomes and denominators, and discuss why the clinic’s estimate may differ from a national or online figure.

how People Run It

Book a visit if you have reached the 12-month or 6-month clock, or sooner if periods or known disease say so. Book an evaluation when the age-and-duration threshold is reached, or earlier when there is a known concern. Bring cycle records, trying time, medicines and relevant surgery or treatment history. If a partner contributes sperm, ask how parallel assessment will be organized. Leave with the named first tests and a date or condition for reviewing the results.
Prepare a concise reproductive history. Write how long pregnancy has been attempted, whether cycles are regular and any previous pregnancies or relevant treatments. ASRM uses this history to select the evaluation, so uncertainty in dates can be recorded honestly. Existing records may be more useful than purchasing a new test before the appointment.
Ask how the assessments will be coordinated. When two partners contribute eggs and sperm, the initial workup can proceed in parallel. ASRM’s approach helps avoid a long sequential process that overlooks one contributor. Ask who orders each test, where the results go and when someone will explain the combined findings.
Ask what decision an AMH test would change. ASRM distinguishes predicting response to ovarian stimulation from predicting unassisted pregnancy. A proposed test should have a stated purpose within the plan. Ask whether the answer would change treatment choice, expected response or timing, and how the clinician would interpret it alongside age and other findings.

how People Keep It

Keep the reason for the evaluation visible. Age, trying time, cycle patterns and known conditions influence when assessment starts. ASRM’s thresholds are clinical decision points rather than a universal waiting requirement. Write down which circumstance applies so the referral question remains clear.
Keep all relevant contributors in the plan. WHO recognizes male, female, combined and unexplained infertility. Parallel assessment can identify more than one contributor and helps organize follow-up. Individual and donor-assisted care still deserve a complete pathway matched to the actual circumstances.
Keep a record of what each test found. A named test answers a limited question: ovulation, semen characteristics or a structural issue, for example. ASRM’s evaluation framework connects those questions to next steps. Retain the result and interpretation so repeating a test is a reasoned decision rather than the default at each new appointment.
Keep reserve measurements in context. AMH helps describe anticipated ovarian response and is not a fertility verdict. ASRM cautions against using a single low measurement to refuse care. Record what the clinician says the result can and cannot predict before treating a change in the number as a change in pregnancy chances.
Keep treatment goals and review points explicit. WHO frames care around findings and preferences, while CDC outcome reporting shows why treatment percentages need careful definitions. Ask whether the goal is ovulation, pregnancy or live birth and how long the proposed step will be assessed. A shared review point makes it easier to reconsider burden, cost and alternatives.

claims Notes

Use 12 months, or 6 months at 35 and older, as evaluation clocks. Claim: “Evaluation is usually offered after 12 months of trying, or after 6 months at 35 and older” — established. ASRM’s 2021 evaluation opinion supplies the usual age-based clocks, with earlier assessment for known concerns and potentially immediate assessment over 40. The 2023 definition is a separate document. An evaluation threshold does not predict whether a particular person can conceive.
Bring both partners into the first workup. Claim: “Infertility workups can skip semen analysis” — not what the research found. When a male partner contributes sperm, ASRM recommends parallel assessment and semen analysis as part of the initial evaluation. Donor-assisted and individual pathways are adapted to their circumstances. Testing one contributor alone can miss information that changes treatment.
Use AMH as a specialist planning tool, not as a home fertility number. Claim: “An AMH kit from the internet can tell you whether you can conceive” — not what the research found. ASRM identifies AMH as useful for anticipating ovarian response, with limited independent ability to predict pregnancy. It cannot determine natural-conception potential by itself. A result belongs beside age, history and the rest of the assessment.
Treat IVF as one option with limits. Claim: “IVF guarantees a baby” — not what the research found. IVF has several stages and does not guarantee pregnancy or live birth. CDC outcome reports use different denominators and patient groups, so an estimate should state both what is counted and who is included. A clinic should explain how its estimate relates to the proposed treatment.
Treat PCOS as a named ovulatory diagnosis when it fits. Claim: “PCOS is a named ovulatory diagnosis that a clinician can evaluate” — established. The international PCOS guideline describes a clinical assessment and specific treatment pathways for ovulatory infertility. The diagnosis does not exclude other fertility contributors. Ask what findings establish it and which part of the evaluation remains necessary.
Ask for evaluation on the clock rather than waiting on folklore. Claim: “You should try privately for many years before seeing anyone” — popular talk. ASRM’s guidance gives clinical reasons to begin evaluation well before a wait of many years. Age, absent or irregular periods and known reproductive risks can shorten the timeline further. Asking for assessment is a way to obtain information, not an admission that the outcome is settled.
Read unexplained infertility as a real category, not as a dismissal. Claim: “Unexplained infertility means nothing can be done” — not what the research found. Unexplained infertility means a standard workup has not identified a cause. It does not mean every reproductive process is proven normal, or that no further care is available. Ask what was assessed and how age, trying time and preferences shape the remaining options.

deep Dive

Distinguish a definition from an evaluation pathway. ASRM’s 2023 definition describes who may need fertility care, including people whose circumstances require medical intervention to achieve pregnancy, and includes the usual age-and-duration evaluation thresholds. The 2021 evaluation opinion adds the fuller workup and earlier-assessment exceptions. Read them together: the public definition should not be used to deny an earlier assessment when history or circumstances already indicate a need.
Read the public definition together with the clinical exceptions. CDC uses a one-year description to explain infertility in public-health language. The clinical assessment also considers age and known causes, as ASRM details. This is why a definition on a public page and a recommendation to seek help sooner can both be correct. For an appointment, bring the specific concern rather than trying to fit every circumstance into a single anniversary.
Use the current NICE guideline with its jurisdiction in view. NICE replaced CG 156 with NG 257 in March 2026. Preserve CG 156 as historical background, but follow links to the current investigation and treatment guidance when checking a recommendation. NICE describes an England-focused care pathway; its referral thresholds and service-access recommendations should not be silently presented as US insurance entitlement or as identical to ASRM. Ask which local service rule governs the actual referral.
Read semen analysis as a measurement that needs interpretation. Semen analysis assesses several features of a sample rather than returning a single fertile-or-infertile verdict. ASRM includes it early when a male partner contributes sperm. Sample conditions and biological variation matter, so an abnormal result may lead to repeat testing and a specialist assessment. Ask what feature was abnormal and what follow-up would distinguish a transient finding from a persistent problem.
Separate expected egg yield from pregnancy potential. ASRM’s ovarian-reserve opinion finds AMH and antral-follicle count useful for anticipating response to stimulation. They are much weaker independent predictors of pregnancy or live birth and are not recommended as general fertility screening for people with untested fertility. A very low value alone should not be used to deny IVF. The useful discussion is what the result changes in treatment planning, not whether it supplies a personal guarantee.
Connect the PCOS treatment recommendation to its eligibility conditions. The 2023 international guideline led by Teede and colleagues supports letrozole as a first-line ovulation-induction medicine for anovulatory infertility in PCOS when other infertility factors are absent. That qualification matters: a sperm or tubal problem can change the plan. The recommendation explains a clinician-directed pathway and is not a prescription or dosing protocol for everyone with irregular cycles. Monitoring and the rest of the evaluation remain part of care.
Read the denominator beneath a clinic success rate. CDC distinguishes outcomes per cycle, retrieval and transfer, as well as cumulative and noncumulative results. A per-transfer live-birth rate excludes attempts that never reached transfer, so it answers a different question from a rate per started cycle. Also check whether the result concerns pregnancy or live birth, the egg source, age group and reporting period. These details make comparisons meaningful without turning group statistics into a personal prediction.
Ask what structural finding would change treatment. ASRM evaluates the uterus and fallopian tubes when indicated by the history and workup. Imaging can lead to a more focused question about whether a procedure would improve the relevant outcome. Surgery is a selected option, not a default response to an unexplained result. Ask what the proposed operation addresses, its alternatives and how recovery or delay fits the wider fertility plan.
Include emotional and financial support in fertility care. WHO’s 2025 guideline recognizes distress, stigma and financial hardship as part of the experience and calls for access to ongoing psychosocial support. This support accompanies biological assessment rather than implying distress caused the fertility problem. Ask the clinic what counseling, social-work or cost-navigation help is available and whether it is separate from treatment sales. A decision to pause or reassess care can be discussed without reducing it to motivation or blame.

related

sleep
nutrition
meaning

watch For Long

Good to know. This is a reading companion, not a diagnosis, not a fertility-clinic visit, and not an intimacy or dating guide. Persistent inability to conceive, repeated miscarriage, or known reproductive disease belongs with a qualified clinician. This page does not promise a pregnancy.
Not advice. Named sources. Honest paraphrase of the finding. Not medical, legal, or financial advice.

sources

Marcelle Cedars. reproductive endocrinologist; ASRM leadership. Relevant work: evaluation and ovarian-reserve teaching.
Richard Legro. reproductive endocrinologist; PCOS and infertility trials. Relevant work: PCOS and ovulation-induction evidence.
Anuja Dokras. reproductive endocrinologist; PCOS research. Relevant work: PCOS as a named ovulatory cause.
Peter Schlegel. urologist; male infertility. Relevant work: male-factor evaluation.
Samantha Pfeifer. reproductive endocrinologist; ASRM practice committee. Relevant work: ASRM committee opinions.
Clarisa Gracia. reproductive endocrinologist; fertility preservation and evaluation. Relevant work: clinical evaluation pathways.
Tommaso Falcone. reproductive surgeon; ASRM education. Relevant work: structural causes and surgery limits.
Bradley Van Voorhis. reproductive endocrinologist; IVF outcomes research. Relevant work: IVF as one option with limits.
Bart Fauser. reproductive endocrinologist; ovarian stimulation research. Relevant work: ovarian-response science.
Scott Nelson. reproductive endocrinologist; AMH research. Relevant work: AMH as a specialist test with limits.
Helena Teede. endocrinologist; international PCOS guideline. Relevant work: PCOS international guidance.
ASRM Practice Committee. professional society practice committee. Relevant work: committee opinions on definition and evaluation.
CDC Division of Reproductive Health. US public-health fertility pages. Relevant work: public definition and timing.
NICE fertility guideline authors. UK fertility assessment and treatment guideline. Relevant work: UK evaluation pathway.
World Health Organization infertility pages. WHO public infertility fact sheets. Relevant work: infertility as a public-health condition.

source Links

CDC-INF

name

Centers for Disease Control and Prevention. Infertility: Frequently Asked Questions.

kind

evidence

links

label
Source
href
https://www.cdc.gov/reproductive-health/infertility-faq/

ASRM-DEF-2023

name

Practice Committee of the American Society for Reproductive Medicine. Definition of infertility: a committee opinion.

kind

evidence

links

label
Source
href
https://www.asrm.org/practice-guidance/practice-committee-documents/definition-of-infertility-a-committee-opinion/

NICE-CG156

name

National Institute for Health and Care Excellence. Fertility problems: assessment and treatment (CG156).

kind

evidence

links

label
Source
href
https://www.nice.org.uk/guidance/cg156

WHO-INF

name

World Health Organization. Infertility fact sheet.

kind

evidence

links

label
Source
href
https://www.who.int/news-room/fact-sheets/detail/infertility

ASRM-EVAL

name

ASRM Practice Committee diagnostic-evaluation committee opinions.

kind

evidence

links

label
Source
href
https://www.asrm.org/

PCOS-TEDE

name

Teede HJ, Misso ML, Costello MF, et al. International evidence-based guideline for the assessment and management of polycystic ovary syndrome.

kind

evidence

links

label
Source
href
https://pubmed.ncbi.nlm.nih.gov/?term=Teede+international+PCOS+guideline

AMH-NELSON

name

Nelson SM and colleagues. Anti-Mullerian hormone papers in fertility assessment.

kind

evidence

links

label
Source
href
https://pubmed.ncbi.nlm.nih.gov/?term=Nelson+SM+anti-Mullerian+hormone

MALE-SCHLEGEL

name

Schlegel PN. Male infertility evaluation reviews.

kind

evidence

links

label
Source
href
https://pubmed.ncbi.nlm.nih.gov/?term=Schlegel+PN+male+infertility+evaluation

IVF-VANVOORHIS

name

Van Voorhis BJ. IVF outcome and counseling papers.

kind

evidence

links

label
Source
href
https://pubmed.ncbi.nlm.nih.gov/?term=Van+Voorhis+IVF+outcomes

ASRM-AGE

name

ASRM Practice Committee. Female age-related fertility decline committee opinion.

kind

evidence

links

label
Source
href
https://www.asrm.org/

CEDARS-INF-2026

name

Marcelle Cedars

kind

professional

links

label
Source
href
https://pubmed.ncbi.nlm.nih.gov/?term=Cedars+MI+infertility

LEGRO-INF-2026

name

Richard Legro

kind

professional

links

label
Source
href
https://pubmed.ncbi.nlm.nih.gov/?term=Legro+RS+infertility

DOKRAS-INF-2026

name

Anuja Dokras

kind

professional

links

label
Source
href
https://pubmed.ncbi.nlm.nih.gov/?term=Dokras+A+PCOS

SCHLEGEL-INF-2026

name

Peter Schlegel

kind

professional

links

label
Source
href
https://pubmed.ncbi.nlm.nih.gov/?term=Schlegel+PN+male+infertility

PFEIFER-INF-2026

name

Samantha Pfeifer

kind

professional

links

label
Source
href
https://pubmed.ncbi.nlm.nih.gov/?term=Pfeifer+S+infertility

GRACIA-INF-2026

name

Clarisa Gracia

kind

professional

links

label
Source
href
https://pubmed.ncbi.nlm.nih.gov/?term=Gracia+CR+infertility

FALCONE-INF-2026

name

Tommaso Falcone

kind

professional

links

label
Source
href
https://pubmed.ncbi.nlm.nih.gov/?term=Falcone+T+infertility

VANVOORHIS-INF-2026

name

Bradley Van Voorhis

kind

professional

links

label
Source
href
https://pubmed.ncbi.nlm.nih.gov/?term=Van+Voorhis+BJ+IVF

FAUSER-INF-2026

name

Bart Fauser

kind

professional

links

label
Source
href
https://pubmed.ncbi.nlm.nih.gov/?term=Fauser+BC+infertility

NELSON-INF-2026

name

Scott Nelson

kind

professional

links

label
Source
href
https://pubmed.ncbi.nlm.nih.gov/?term=Nelson+SM+AMH

TEDE-INF-2026

name

Helena Teede

kind

professional

links

label
Source
href
https://pubmed.ncbi.nlm.nih.gov/?term=Teede+HJ+PCOS+guideline

ASRM-INF-2026

name

ASRM Practice Committee

kind

professional

links

label
Source
href
https://www.asrm.org/

CDC-INF-2026

name

CDC Division of Reproductive Health

kind

professional

links

label
Source
href
https://www.cdc.gov/reproductive-health/infertility-faq/

NICE-INF-2026

name

NICE fertility guideline authors

kind

professional

links

label
Source
href
https://www.nice.org.uk/guidance/cg156

WHO-INF-2026

name

World Health Organization infertility pages

kind

professional

links

label
Source
href
https://www.who.int/news-room/fact-sheets/detail/infertility

ASRM-EVAL-2021-EXACT

name

ASRM: Fertility evaluation of infertile women (2021). Source

kind

evidence

links

label
Source
href
https://www.asrm.org/practice-guidance/practice-committee-documents/fertility-evaluation-of-infertile-women-a-committee-opinion-2021/

ASRM-RESERVE-2020-EXACT

name

ASRM: Testing and interpreting measures of ovarian reserve. Source

kind

evidence

links

label
Source
href
https://www.asrm.org/practice-guidance/practice-committee-documents/testing-and-interpreting-measures-of-ovarian-reserve-a-committee-opinion-2020/

WHO-INF-GUIDELINE-2025

name

WHO issues first global guideline on infertility. Source

kind

evidence

links

label
Source
href
https://www.who.int/news/item/28-11-2025-who-issues-first-global-guideline-on-infertility

CDC-ART-TECH-2024

name

CDC: NASS Technical Notes. Source

kind

evidence

links

label
Source
href
https://www.cdc.gov/art/php/nass/technical-notes.html

ASRM-DEF-2023-EXACT

name

ASRM: Definition of infertility (2023). Source

kind

evidence

links

label
Source
href
https://www.asrm.org/practice-guidance/practice-committee-documents/definition-of-infertility/

ASRM-PCOS-2023-EXACT

name

2023 International Evidence-based Guideline for PCOS. Source

kind

evidence

links

label
Source
href
https://integration.asrm.org/globalassets/_asrm/practice-guidance/practice-guidelines/pdf/recommendations_from_the_2023_int_evidence-based_guideline_on_pcos.pdf

NICE-NG257-2026

name

NICE NG 257: Fertility problems—assessment and treatment. Source

kind

evidence

links

label
Source
href
https://www.nice.org.uk/guidance/ng257

source Claims

watch For

CDC-INF
ASRM-DEF-2023
CEDARS-INF-2026

situations.when-to-ask

CDC-INF
ASRM-DEF-2023
NICE-CG156
CEDARS-INF-2026
CDC-INF-2026
ASRM-EVAL-2021-EXACT

situations.both-partners

WHO-INF
ASRM-EVAL
MALE-SCHLEGEL
SCHLEGEL-INF-2026
NICE-CG156
ASRM-EVAL-2021-EXACT
ASRM-DEF-2023
ASRM-DEF-2023-EXACT

situations.tests

ASRM-EVAL
PFEIFER-INF-2026
GRACIA-INF-2026
AMH-NELSON
NELSON-INF-2026
ASRM-EVAL-2021-EXACT
ASRM-RESERVE-2020-EXACT

situations.next-options

IVF-VANVOORHIS
VANVOORHIS-INF-2026
FAUSER-INF-2026
LEGRO-INF-2026
PCOS-TEDE
NICE-CG156
WHO-INF-GUIDELINE-2025
CDC-ART-TECH-2024
ASRM-PCOS-2023-EXACT

split.established.0

CDC-INF
ASRM-DEF-2023
CEDARS-INF-2026
ASRM-AGE
ASRM-EVAL-2021-EXACT

split.established.1

WHO-INF
MALE-SCHLEGEL
SCHLEGEL-INF-2026
NICE-CG156
ASRM-EVAL-2021-EXACT

split.established.2

ASRM-EVAL
PFEIFER-INF-2026
GRACIA-INF-2026
FALCONE-INF-2026
ASRM-EVAL-2021-EXACT

split.established.3

ASRM-AGE
CDC-INF
CEDARS-INF-2026
ASRM-EVAL-2021-EXACT

split.established.4

PCOS-TEDE
TEDE-INF-2026
LEGRO-INF-2026
DOKRAS-INF-2026
ASRM-PCOS-2023-EXACT

split.established.5

IVF-VANVOORHIS
VANVOORHIS-INF-2026
FAUSER-INF-2026
NICE-CG156
CDC-ART-TECH-2024

split.disputed.0

AMH-NELSON
NELSON-INF-2026
ASRM-EVAL
CEDARS-INF-2026
ASRM-RESERVE-2020-EXACT

split.disputed.1

NICE-CG156
ASRM-DEF-2023
ASRM-INF-2026
WHO-INF-GUIDELINE-2025

split.disputed.2

CDC-INF
WHO-INF
CDC-INF-2026
WHO-INF-GUIDELINE-2025

split.disputed.3

ASRM-EVAL
NICE-CG156
GRACIA-INF-2026
ASRM-EVAL-2021-EXACT
NICE-NG257-2026

split.talk.0

CDC-INF
ASRM-DEF-2023
ASRM-EVAL-2021-EXACT

split.talk.1

WHO-INF
MALE-SCHLEGEL
SCHLEGEL-INF-2026
ASRM-EVAL-2021-EXACT

split.talk.2

AMH-NELSON
NELSON-INF-2026
ASRM-RESERVE-2020-EXACT

split.talk.3

IVF-VANVOORHIS
NICE-CG156
CDC-ART-TECH-2024

move

CDC-INF
ASRM-DEF-2023
NICE-CG156
ASRM-EVAL-2021-EXACT

try.0

ASRM-DEF-2023
CDC-INF
ASRM-EVAL-2021-EXACT

try.1

ASRM-EVAL
MALE-SCHLEGEL
ASRM-EVAL-2021-EXACT

try.2

AMH-NELSON
CEDARS-INF-2026
ASRM-RESERVE-2020-EXACT

keep.0

CDC-INF
ASRM-DEF-2023
ASRM-EVAL-2021-EXACT

keep.1

WHO-INF
NICE-CG156
SCHLEGEL-INF-2026
ASRM-EVAL-2021-EXACT

keep.2

ASRM-EVAL
PFEIFER-INF-2026
ASRM-EVAL-2021-EXACT

keep.3

AMH-NELSON
NELSON-INF-2026
ASRM-RESERVE-2020-EXACT

keep.4

IVF-VANVOORHIS
NICE-CG156
WHO-INF-GUIDELINE-2025
CDC-ART-TECH-2024

deep.0

ASRM-DEF-2023
ASRM-INF-2026
CEDARS-INF-2026
WHO-INF-2026
ASRM-DEF-2023-EXACT
ASRM-EVAL-2021-EXACT

deep.1

CDC-INF
CDC-INF-2026
ASRM-EVAL-2021-EXACT

deep.2

NICE-CG156
NICE-INF-2026
NICE-NG257-2026

deep.3

MALE-SCHLEGEL
WHO-INF
SCHLEGEL-INF-2026
ASRM-EVAL-2021-EXACT

deep.4

AMH-NELSON
NELSON-INF-2026
FAUSER-INF-2026
ASRM-RESERVE-2020-EXACT

deep.5

PCOS-TEDE
TEDE-INF-2026
LEGRO-INF-2026
DOKRAS-INF-2026
ASRM-PCOS-2023-EXACT

deep.6

IVF-VANVOORHIS
VANVOORHIS-INF-2026
NICE-CG156
CDC-ART-TECH-2024

deep.7

FALCONE-INF-2026
ASRM-EVAL
ASRM-EVAL-2021-EXACT

deep.8

ASRM-DEF-2023
CDC-INF
WHO-INF
WHO-INF-GUIDELINE-2025

claims.0

CDC-INF
ASRM-DEF-2023
ASRM-EVAL-2021-EXACT
ASRM-DEF-2023-EXACT

claims.1

WHO-INF
NICE-CG156
MALE-SCHLEGEL
ASRM-EVAL-2021-EXACT

claims.2

AMH-NELSON
ASRM-EVAL
ASRM-RESERVE-2020-EXACT

claims.3

IVF-VANVOORHIS
NICE-CG156
CDC-ART-TECH-2024

claims.4

PCOS-TEDE
LEGRO-INF-2026
ASRM-PCOS-2023-EXACT

claims.5

CDC-INF
ASRM-DEF-2023
ASRM-EVAL-2021-EXACT

claims.6

ASRM-EVAL
NICE-CG156
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NICE-NG257-2026

source Situation Keys

situations.when-to-ask
situations.both-partners
situations.tests
situations.next-options

professional Source Ids

CEDARS-INF-2026
LEGRO-INF-2026
DOKRAS-INF-2026
SCHLEGEL-INF-2026
PFEIFER-INF-2026
GRACIA-INF-2026
FALCONE-INF-2026
VANVOORHIS-INF-2026
FAUSER-INF-2026
NELSON-INF-2026
TEDE-INF-2026
ASRM-INF-2026
CDC-INF-2026
NICE-INF-2026
WHO-INF-2026

house Pointers

href
/self/
label
STUDself. For everyday sleep and food habits, see STUDself.

positive Guidance

status: DONE
reviewed At: 2026-09-18
professional Count: 15
scope: content-and-positive-titles-only

learn Article

article

format version

presentation

complete-card

overview

sections

id
understanding-fertility
role
explanation
title
Understand what fertility evaluation can answer
intro
TTC means trying to conceive. The useful first question is whether it is time to seek an assessment, then what the assessment needs to explain.
items
- label
  Follow the reproductive steps to understand the tests
  text
  A pregnancy requires more than one normal hormone number. An ovary releases an egg; sperm must fertilize it; the developing embryo must reach the uterus and implant in its lining. CDC explains that difficulty at one or several of these steps can contribute to infertility. That is why a workup considers ovulation, sperm, the uterus and fallopian tubes together. It is a search for information that changes care, rather than a competition to identify whose body is responsible. A prior pregnancy also does not prove that every step is working now.
  source ids
  cdc-infertility
  who-infertility
- label
  Use the definition to ask for care that fits your circumstances
  text
  Infertility describes difficulty achieving a successful pregnancy; it does not mean pregnancy is certainly impossible. WHO distinguishes primary infertility, when no pregnancy has been achieved, from secondary infertility after a previous pregnancy. ASRM's 2023 definition also includes people who need medical intervention to achieve pregnancy, including individual and donor-assisted pathways. This matters because someone should not have to fit a two-person trying timeline to receive a relevant assessment. The history and intended conception pathway establish which questions need answering; relationship status alone should not delay care.
  source ids
  who-infertility
  asrm-definition
- label
  Bring previous pregnancy losses into the medical conversation
  text
  Getting pregnant and carrying a pregnancy to delivery are related but different clinical questions. CDC notes that reproductive endocrinologists may also help with recurrent pregnancy loss, described there as two or more spontaneous miscarriages. Repeated losses deserve a clinician's assessment rather than automatically restarting the usual waiting clock for difficulty conceiving. Bring the dates, gestational stages and available records. A clinician can explain whether a fertility evaluation, a pregnancy-loss evaluation or both are appropriate; this article cannot diagnose the cause from a history of loss.
  source ids
  cdc-infertility
id
when-to-seek-evaluation
role
application
title
Know when to start the conversation
items
- label
  Ask for evaluation after the usual age-and-duration threshold
  text
  For someone trying without a known fertility concern, ASRM uses 12 months when the person attempting pregnancy with their own eggs is under 35 and six months at 35 or older. These thresholds guide when to begin an assessment. They do not say that pregnancy before the deadline is guaranteed or that pregnancy after it is impossible. Age informs planning because reproductive potential changes with time, but a birthday is not an individual diagnosis. Write down the duration honestly, including pauses or uncertainty, so the clinician can apply the guidance to the actual history. Consider two invented referral notes. One says only 'We have been trying for a while.' The other gives the person's age, an approximate start date, any pauses and a known concern they want to discuss. The second supplies information a clinician can use to decide how the general timing guidance applies. It does not require the person to know which test or treatment will follow. If there is uncertainty about the timeline, mark it rather than invent precision. If a known concern is present, include it instead of waiting solely to complete a calendar interval. The resulting appointment may clarify what to assess, which existing records are useful and who coordinates the next step. It cannot promise an explanation from one test or a pregnancy from evaluation. This example makes the threshold a route into assessment, rather than a verdict about an individual outcome.
  source ids
  asrm-definition
  cdc-infertility
- label
  Discuss known concerns before waiting for an anniversary
  text
  ASRM's evaluation opinion supports assessment without delay when a history suggests impaired fertility. Missing or irregular periods, suspected tubal or uterine disease, endometriosis, a known sperm problem and previous treatments that can damage reproductive function are examples. Over 40, a more immediate evaluation may be warranted. A referral request can name the concern directly: 'My periods have stopped' or 'I had chemotherapy and want to understand fertility.' The clinician decides the appropriate tests; the useful action is bringing the concern forward, rather than waiting simply because twelve months have not passed.
  source ids
  asrm-evaluation
- label
  Coordinate assessment of every relevant reproductive contributor
  text
  When a male partner provides sperm, evaluation should run alongside the assessment of the person who may carry the pregnancy. AUA/ASRM guidance makes reproductive history and semen analysis early parts of that workup. This can prevent months of testing one person before recognizing a contributor in the other, and more than one factor can coexist. For donor-assisted or individual care, ask what evaluation fits that pathway. 'Both partners' describes one common arrangement; it is not a universal entry requirement or a reason to deny assessment.
  source ids
  male-evaluation
  asrm-definition
- label
  Use the first visit to obtain a plan rather than a shopping list
  text
  A consultation does not obligate someone to IVF. ASRM's patient overview describes starting with histories and previous records, then deciding which tests or referrals are useful. A reproductive endocrinologist is an obstetrician-gynecologist with additional fertility training; a reproductive urologist evaluates male infertility. Some first steps can begin with an existing clinician. Ask who will coordinate the results, what each test would change and when the findings will be explained together. A clear first appointment should reduce uncertainty about the process even when it cannot settle the outcome.
  source ids
  asrm-overview
  lobo-evaluation
id
what-first-tests-mean
role
findings
title
Understand the named first tests
items
- label
  Use cycle history to ask whether ovulation is occurring
  text
  Ovulation means releasing an egg from an ovary. Regular periods often supply useful evidence, while long gaps or absent periods can point toward an ovulation problem that needs an explanation. ASRM says that regular 21–35-day cycles usually do not require extra confirmation, with exceptions such as signs of excess androgen activity. If confirmation is needed, a progesterone blood test can show recent ovulation when timed about a week before the expected next period. A fixed 'day 21' test does not fit every cycle. One measurement also cannot grade the entire quality of the cycle.
  source ids
  asrm-evaluation
- label
  Read semen analysis as several measurements with context
  text
  Semen analysis measures features of a collected sample, including sperm concentration, movement and shape. AUA/ASRM explains that a value above or below a reference limit cannot, by itself, classify someone as fertile or infertile. Samples also vary, so an abnormal first result commonly needs repeat testing and a reproductive-urology review. Ask what was measured, whether collection conditions affected interpretation and what a repeat would clarify. The combined pattern and medical history matter more than treating one flagged number as a verdict; a normal sample does not answer every fertility question either.
  source ids
  male-evaluation
  lobo-evaluation
- label
  Ask which structural question an imaging test answers
  text
  HSG means hysterosalpingography: dye is introduced through the cervix and X-ray imaging follows it through the uterus and fallopian tubes. It can help assess the uterine cavity and whether the tubes appear open. NICHD also describes ultrasound and saline-based imaging for looking inside the uterus. These tests answer different questions, so one result need not replace every other assessment. Ask what the clinician is looking for and what an abnormal finding would lead to. 'The tubes appear open' does not prove every reproductive process is normal.
  source ids
  nichd-diagnosis
- label
  Use AMH and follicle counts to plan ovarian stimulation
  text
  Ovarian reserve refers mainly to the remaining egg supply; egg quantity and egg quality are different ideas. AMH, or anti-Müllerian hormone, is a hormone associated with small growing follicles. Antral follicle count is an ultrasound count of visible small follicles. ASRM finds these measures useful for anticipating response to medicines that stimulate the ovaries and expected egg yield. They cannot independently predict unassisted conception or guarantee a live birth. A very low AMH alone should not be used to deny IVF. Ask what decision the result changes, alongside age, diagnosis and any previous treatment response. ASRM discourages general reserve screening when fertility is untested.
  source ids
  asrm-reserve
- label
  Let a specific finding guide further testing or surgery
  text
  A larger test panel is not automatically a more useful evaluation. ESHRE's unexplained-infertility guideline identifies many additional tests with limited evidence and discourages routine testing that does not establish a useful cause. Surgery also needs a defined target and an expected benefit. ASRM does not recommend routine laparoscopy for infertility without a suspected pelvic problem or another indication. If a procedure is proposed, ask what it addresses, what less invasive alternatives exist and how recovery or delay affects the wider plan. Finding a difference in anatomy is the start of interpretation, not a treatment instruction.
  source ids
  eshre-ui
  asrm-evaluation
  nichd-diagnosis
id
how-treatment-options-differ
role
findings
title
Connect treatment options to the findings
items
- label
  Match an ovulation medicine to a diagnosed ovulation problem
  text
  PCOS, or polycystic ovary syndrome, is a clinically assessed hormonal and metabolic condition that can disrupt ovulation. Anovulation means eggs are not being released; irregular cycles can have other causes too. Teede and colleagues' 2023 international guideline recommends letrozole as first-line medicine for infertility caused by anovulation in PCOS when other infertility factors are absent. That qualification matters: sperm or tubal findings may change care. Letrozole remains off-label for this use in many countries and requires clinician assessment, including excluding an existing pregnancy. The recommendation explains a pathway; it is not a prescription for every person with PCOS.
  source ids
  pcos-guideline
- label
  Read a treatment trial's actual population and outcome
  text
  Legro and colleagues randomly assigned 750 women with PCOS to letrozole or clomiphene for up to five cycles. Cumulative live birth occurred in 103 of 374 women receiving letrozole, about 28%, compared with 72 of 376, about 19%, receiving clomiphene. The difference was roughly eight additional live births per 100 participants in this selected trial population. It was not a chance per monthly cycle and did not establish a guarantee for an individual. NIH's explanation makes the practical point clear: knowing the cause of infertility can identify a treatment with better evidence for that cause.
  source ids
  legro-trial
  nih-pcos
- label
  Understand what IUI changes and what it still relies on
  text
  Intrauterine insemination, or IUI, places prepared sperm directly into the uterus. Fertilization still has to occur inside the body, so its usefulness depends on the relevant ovulation, sperm and tubal circumstances. HFEA explains that it is a different procedure from IVF, with different suitability and burdens; it should not be sold simply as a cheaper version of the same treatment. It may be combined with ovarian stimulation in selected circumstances. Ask why IUI fits the findings, what monitoring is needed and what would lead the team to reconsider it.
  source ids
  hfea-iui
  male-treatment
- label
  Follow the stages of IVF before interpreting its promise
  text
  In vitro fertilization, or IVF, involves collecting eggs and fertilizing them in a laboratory; a resulting embryo may then be transferred to the uterus. HFEA explains the separate stages because treatment can stop before transfer, and transfer does not ensure implantation, pregnancy or live birth. Medicines, scans, egg collection and possible later frozen transfers also create distinct burdens and costs. Ask which stages the estimate covers and what could alter or cancel the plan. IVF can bypass some problems and offer another route to pregnancy, but the name of the procedure does not settle the outcome. Discuss safety as well as success: transferring more embryos can increase multiple-pregnancy risk, and single-embryo-transfer research led by Van Voorhis helps explain why a safer outcome matters.
  source ids
  hfea-ivf
  panel-van-voorhis
id
reading-treatment-outcomes
role
explanation
title
Make success rates understandable
items
- label
  Choose the outcome and denominator before comparing percentages
  text
  A live-birth rate is different from a positive pregnancy-test rate. Its denominator is the group of attempts or people being counted: started cycles, retrievals and transfers answer different questions. CDC's technical notes distinguish these measures and distinguish own-egg from donor-egg results. A per-transfer rate leaves out attempts that never reached transfer. Cumulative reporting can combine outcomes from linked transfers after a retrieval within a defined reporting window. Before comparing clinics, ask for the outcome, denominator, age group, egg source and timeframe. A larger percentage may describe a narrower group rather than better overall prospects.
  source ids
  cdc-art-notes
- label
  Use comparable group data to ask a better personal question
  text
  Imagine a hypothetical report with 100 started cycles, 80 transfers and 32 live births. The same results would be 32% per started cycle and 40% per transfer. This illustration is arithmetic, not a national or clinic statistic. CDC provides official clinic data and an IVF estimator, but a group estimate still needs a clinician's explanation of how the patient and proposed treatment resemble that group. A successful online story can offer support; it cannot replace comparable data. Ask why the estimate applies and which important uncertainties it leaves out.
  source ids
  cdc-art-notes
  cdc-art-rates
id
where-care-choices-differ
role
perspectives
title
Understand where reasonable care choices differ
items
- label
  Ask what unexplained infertility means after the workup
  text
  Unexplained infertility is a diagnosis of exclusion: the standard evaluation has not identified a cause. ESHRE emphasizes that this category depends on completing the appropriate basic assessment. It does not prove every biological process is normal, and it does not mean the difficulty is imagined or that care has ended. It also does not make every extra test useful. Ask which questions have been answered and what remains unknown. That distinction lets the discussion move toward options and their evidence without turning uncertainty into an unlimited search for a hidden diagnosis.
  source ids
  eshre-ui
- label
  Agree on a treatment sequence and a point for reassessment
  text
  For unexplained infertility, ESHRE's 2023 guideline recommends stimulated IUI as a first-line treatment and uses prognosis to decide when to begin. NICE's 2026 England-focused guidance instead describes trying for a total of two years before treatment in its specified pathway. That is distinct from the earlier evaluation: tests and consultation can begin before active treatment. The differences concern prognosis, treatment timing and care systems, not whether the difficulty is real. Ask which current local guidance applies, how age and previous results affect waiting, and what would prompt reassessment rather than treating either timeline as universal.
  source ids
  eshre-ui
  nice-ui
- label
  Compare guideline approaches with their dates and populations
  text
  Treatment recommendations can differ over stimulation medicines as well as when to use IVF. NICE's 2026 pathway includes considering up to four gonadotropin-stimulated IUI cycles or offering IVF after discussion; ESHRE stresses low-dose regimens and monitoring to reduce multiple pregnancy and ovarian hyperstimulation syndrome, an excessive ovarian response. Historical ASRM guidance favored oral-agent IUI and discouraged gonadotropin-IUI, but its page lists a March 2024 expiration. These differences need a current clinician's interpretation. Ask why this regimen fits, what safeguards are used and when it will be reviewed; this article does not select medicines or doses.
  source ids
  nice-ui
  eshre-ui
  asrm-ui-historical
- label
  Ask whether an optional extra improves the outcome that matters
  text
  Treatment add-ons are extra tests or procedures offered alongside standard care. HFEA rates evidence by outcome and sometimes by patient group; lack of adequate evidence is different from trials showing no benefit. An improvement in a laboratory measure or a per-transfer statistic may not mean more live births across treatment. Ask which comparable patients were studied, the absolute benefit, possible harms and extra cost. A justified use for one condition does not make an add-on necessary for everyone. Forum disagreements about embryo testing prompted this question; the regulator's evidence, not the discussion's popularity, supports it.
  source ids
  hfea-addons
- label
  Ask which patients benefit from embryo chromosome screening
  text
  PGT-A tests a sample of embryo cells for an abnormal chromosome count before a possible transfer. The unresolved question is whether selection improves the total chance of a live birth for the particular patient, not simply whether a selected embryo has a favorable transfer outcome. ASRM's 2024 opinion says a routine benefit for all IVF patients has not been demonstrated and describes limitations in studies of selected groups. Ask about cumulative live birth, miscarriage, inconclusive results, costs and what happens to embryos with uncertain findings. Screening evidence should be discussed separately from testing for a known inherited disorder.
  source ids
  asrm-pgta
- label
  Balance health improvements with the cost of delaying care
  text
  Weight can affect ovulation, pregnancy health and the safety of fertility procedures, but improving a health measure does not automatically improve every fertility outcome. ASRM's obesity opinion reports that weight-loss interventions may improve ovulation in anovulatory women, while trials have not consistently shown better live birth after treatment in ovulatory women. The field must balance possible benefits, procedural safety and the reproductive cost of delay, especially with advancing age. Ask which outcome a proposed delay is intended to improve and what evidence supports it for this situation. This is a care discussion, not a blame assignment or a self-directed weight target.
  source ids
  asrm-weight
id
keeping-care-manageable
role
application
title
Keep the workup useful and manageable
items
- label
  Keep one concise history and the existing reports
  text
  Bring trying duration, cycle patterns, previous pregnancies and losses, relevant surgery, infections, cancer treatment and current medicines or supplements. ASRM's patient overview explains that reviewing existing records can reduce waste from repeated evaluation. Record uncertain dates as uncertain. Keep the original reports beside the clinician's interpretation, rather than only a remembered label such as 'low hormones.' This gives the next clinician something concrete to review and makes it easier to explain why a repeat test is needed.
  source ids
  asrm-overview
  nichd-diagnosis
- label
  Keep the clinical question beside each result
  text
  A useful record has three parts: what was being investigated, what the test found and what happens next. For example, a structural image and a hormone test do not answer the same question. Lobo's public evaluation teaching connects the different tests before discussing a treatment plan. Use that approach when results arrive separately: ask how they fit together. Write down who will explain the combined findings and the follow-up date. This is a way to organize clinical conversations, not a method for diagnosing yourself from reference ranges.
  source ids
  lobo-evaluation
- label
  Discuss medicines and health support without assigning blame
  text
  WHO recommends practical support such as tobacco cessation, activity and a healthy diet alongside fertility care. These steps do not identify the cause of one unsuccessful cycle or guarantee conception. Medication review also matters for sperm: AUA/ASRM explains that external testosterone can suppress sperm production, even when used for another health goal. Bring prescribed medicines, hormones and supplements to the clinician rather than changing them on your own. Ask what support is appropriate now and which changes have evidence for the outcome being discussed.
  source ids
  who-care
  male-treatment
- label
  Include emotional support as part of care
  text
  Waiting, tests and uncertain outcomes can affect daily life, work and finances. WHO's guideline release calls for ongoing psychosocial support, and Cardiff researchers Boivin and Gameiro develop tools and guidance addressing fertility-related well-being and care needs. Counseling is support for someone living through a difficult process; needing it is not evidence that distress caused the infertility. Ask about counseling, peer support or social-work help and whether it is independent of treatment sales. Support can be useful whether care continues, changes or pauses.
  source ids
  who-care
  boivin-profile
  gameiro-profile
- label
  Keep total burden and the review point in the decision
  text
  A treatment decision includes appointments, monitoring, medicines, procedures, travel, work disruption and possible further attempts. WHO recognizes financial barriers, while Gameiro's research addresses how people experience treatment burden and decisions about continuation. Ask for a written estimate of what the proposed step includes and excludes, and verify local coverage directly. NICE's England-focused guidance is not US insurance entitlement; its 2026 NG257 replaced CG156, but detailed access rules need current local confirmation. A pause or second opinion can be discussed without treating it as a failure of commitment.
  source ids
  who-care
  gameiro-profile
  hfea-ivf
  nice-ng257
id
checking-fertility-claims
role
perspectives
title
Check a fertility claim against the evidence
intro
These short judgments connect to the fuller explanations above. A verdict applies to the wording of the claim, not to a person's prognosis.
items
- label
  Use the usual clocks with their exceptions
  text
  Claim: 'Evaluation usually starts at 12 months under 35 or six months at 35 and older.' Verdict: established. ASRM provides these thresholds when no earlier concern is known. Known risks can justify earlier assessment; the clocks do not predict an individual outcome.
  source ids
  asrm-definition
  asrm-evaluation
- label
  Include sperm assessment when sperm is part of the plan
  text
  Claim: 'A workup can routinely skip semen analysis.' Verdict: not. AUA/ASRM includes semen assessment early when applicable. Individual and donor-assisted pathways are adapted to their circumstances.
  source ids
  male-evaluation
- label
  Use AMH for a defined planning question
  text
  Claim: 'An online AMH kit tells me whether I can conceive.' Verdict: not. AMH can inform expected ovarian response; it cannot independently answer natural-conception potential. Keep the report for clinical interpretation.
  source ids
  asrm-reserve
- label
  Ask about live birth with every IVF estimate
  text
  Claim: 'IVF guarantees a baby.' Verdict: not. IVF has stages that may not reach transfer, pregnancy or live birth. An estimate needs its outcome and denominator.
  source ids
  hfea-ivf
  cdc-art-notes
- label
  Connect PCOS care to the demonstrated ovulation problem
  text
  Claim: 'A clinician can evaluate PCOS as an ovulatory contributor.' Verdict: established. The international guideline identifies a clinical pathway, while keeping other infertility contributors in view.
  source ids
  pcos-guideline
- label
  Seek help using the history rather than folklore
  text
  Claim: 'People should wait many years before asking for evaluation.' Verdict: talk. Professional evaluation thresholds and earlier-risk exceptions provide a better starting point. A conversation does not settle the prognosis.
  source ids
  asrm-definition
- label
  Use an unexplained result to discuss the remaining options
  text
  Claim: 'Unexplained infertility means nothing can be done.' Verdict: not. It describes what the standard evaluation has not explained. ESHRE provides further care options while acknowledging substantial uncertainty.
  source ids
  eshre-ui
id
clinical-boundaries
role
cautions
title
Use this understanding with qualified care
items
- label
  Bring persistent difficulty and known disease to a clinician
  text
  This is a reading companion, not a diagnosis, not a fertility-clinic visit, and not an intimacy or dating guide. Persistent inability to conceive, repeated miscarriage, or known reproductive disease belongs with a qualified clinician. This page does not promise a pregnancy. Named sources. Honest paraphrase of the finding. Not medical, legal, or financial advice. The sources explain populations and clinical pathways; a clinician still needs the individual's history, examination and results before selecting tests or treatment.
  source ids
  cdc-infertility
  asrm-definition
id
your-next-step
role
next_steps
title
Leave the next conversation with a clear question
items
- label
  Arrange an assessment when the history calls for one
  text
  The next move is to contact an appropriate clinician when the usual age-and-duration threshold has been reached, or sooner for a known concern. Give your age, how long pregnancy has been attempted, the intended conception pathway and any concern that may justify earlier assessment. If sperm assessment is relevant, ask how it will be coordinated. The goal of this first contact is an evaluation plan with named questions and a follow-up point, rather than choosing a treatment from an online success story.
  source ids
  asrm-definition
  male-evaluation
- label
  Prepare a short history before the visit
  text
  Try-step one: gather existing reproductive records and make a brief timeline of attempts, cycles, previous pregnancies or losses, relevant operations or treatments and medicines. ASRM's overview explains why access to previous records can reduce unnecessary repetition. Add the question you most need answered, such as whether earlier assessment is appropriate or why a particular test is proposed. You do not need a perfectly documented calendar or a purchased hormone panel before asking for help.
  source ids
  asrm-overview
- label
  Ask for the result-to-decision link
  text
  Write down: 'What does this test answer, and what decision will change when we have the result?' For a treatment discussion, add 'What live-birth outcome, risks, total burden and review point apply to people with similar findings?' Lobo's evaluation explanation and WHO's care framework both connect assessment to a plan. Keep the answers with the reports so the next appointment builds on what has already been learned.
  source ids
  lobo-evaluation
  who-care

related

sleep
nutrition
meaning

sources

id
asrm-definition
title
Definition of infertility: a committee opinion (2023)
url
https://www.asrm.org/practice-guidance/practice-committee-documents/definition-of-infertility/
kind
guideline
accessed at
2026-10-01
supports
Inclusive definition; usual 12/6-month evaluation clocks; circumstances requiring intervention; no delay solely by relationship status.
limitations
Definition and professional opinion, not insurance entitlement.
id
asrm-evaluation
title
Fertility evaluation of infertile women: a committee opinion (2021)
url
https://www.asrm.org/practice-guidance/practice-committee-documents/fertility-evaluation-of-infertile-women-a-committee-opinion-2021/
kind
guideline
accessed at
2026-10-01
supports
Earlier evaluation indications; ovulation assessment; test selection; HSG limitations; targeted surgery.
limitations
US specialist guidance, not an individualized workup.
id
asrm-reserve
title
Testing and interpreting measures of ovarian reserve: a committee opinion (2020)
url
https://www.asrm.org/practice-guidance/practice-committee-documents/testing-and-interpreting-measures-of-ovarian-reserve-a-committee-opinion-2020/
kind
guideline
accessed at
2026-10-01
supports
AMH/AFC predict stimulation response better than unassisted pregnancy; low values alone should not deny IVF.
limitations
Older committee opinion; egg quantity and egg quality are distinct. Relevant sections, rather than a new clinical assessment, support this explanation.
id
cdc-infertility
title
Infertility: Frequently Asked Questions
url
https://www.cdc.gov/reproductive-health/infertility-faq/
kind
official
accessed at
2026-10-01
supports
Public-health definition, reproductive steps, age, recurrent pregnancy loss and major contributors.
limitations
Public definitions explicitly do not determine access to individual services.
id
who-infertility
title
Infertility
url
https://www.who.int/news-room/fact-sheets/detail/infertility
kind
official
accessed at
2026-10-01
supports
Primary/secondary infertility; male/female contributors; social and access burdens.
limitations
Global overview; prevalence and risk factors do not identify a personal cause.
id
who-care
title
WHO issues first global guideline on infertility
url
https://www.who.int/news/item/28-11-2025-who-issues-first-global-guideline-on-infertility
kind
official
accessed at
2026-10-01
supports
November 2025 guideline release: progressively selected care, lifestyle support, patient preferences and psychosocial support.
limitations
Guideline release, not a review of the full WHO guideline. No specific treatment algorithm is inferred.
id
male-evaluation
title
Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I (2020)
url
https://www.asrm.org/practice-guidance/practice-committee-documents/diagnosis-and-treatment-of-infertility-in-men-auaasrm-guideline-part-i-2020/
kind
guideline
accessed at
2026-10-01
supports
Parallel assessment, variable semen measurements, repeat abnormal samples, specialist review.
limitations
Based on the 2020 text; the 2024 amendment was unavailable for review. No amended genetic thresholds are used.
id
male-treatment
title
Diagnosis and treatment of infertility in men: AUA/ASRM guideline part II
url
https://www.asrm.org/practice-guidance/practice-committee-documents/diagnosis-and-treatment-of-infertility-in-men-aua-asrm-guideline-part2/
kind
guideline
accessed at
2026-10-01
supports
External testosterone can suppress sperm production; supplements have uncertain value; IUI definition.
limitations
Older guideline text; clinician-directed treatment; no doses or protocols reproduced.
id
pcos-guideline
title
Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome
url
https://integration.asrm.org/globalassets/_asrm/practice-guidance/practice-guidelines/pdf/recommendations_from_the_2023_int_evidence-based_guideline_on_pcos.pdf
kind
guideline
accessed at
2026-10-01
supports
Teede and colleagues: letrozole first-line for anovulatory PCOS infertility without other factors; off-label status and pregnancy exclusion.
limitations
Official 26-page guideline summary, not the complete Monash guideline. The recommendation applies to the specified population.
id
legro-trial
title
Letrozole versus clomiphene for infertility in the polycystic ovary syndrome
url
https://pubmed.ncbi.nlm.nih.gov/25006718/
kind
study
accessed at
2026-10-01
supports
Randomized 750-woman trial, up to five cycles; cumulative live birth 27.5% versus 19.1%.
limitations
Primary abstract; selected PCOS population, not all infertility or per-cycle probabilities.
id
nih-pcos
title
New treatment increases pregnancy rate for women with infertility disorder
url
https://www.nichd.nih.gov/newsroom/releases/070914-PCOS
kind
official
accessed at
2026-10-01
supports
NIH explanation of the 2014 trial, eligible PCOS population and live-birth outcome.
limitations
Historical institutional explanation, not updated prescribing guidance.
id
eshre-ui
title
Unexplained Infertility guideline (2023)
url
https://www.eshre.eu/-/media/sitecore-files/Guidelines/UI/UI-guideline_-Final.pdf
kind
guideline
accessed at
2026-10-01
supports
Diagnosis of exclusion; limited evidence for extras; stimulated IUI as first-line, individualized IVF, monitored low-dose gonadotropins.
limitations
Relevant recommendations from the full European guideline; much of its evidence is low quality.
id
asrm-ui-historical
title
Evidence-based treatments for couples with unexplained infertility: a guideline (2020)
url
https://www.asrm.org/practice-guidance/practice-committee-documents/evidence-based-treatments-for-couples-with-unexplained-infertility-a-guideline-2020/
kind
guideline
accessed at
2026-10-01
supports
Historical US comparison: oral-agent IUI before IVF; cautions about gonadotropin IUI and multiple pregnancy.
limitations
The source lists a March 2024 expiration. Used only for a labeled historical comparison, not a current U.S. treatment algorithm.
id
hfea-ivf
title
In vitro fertilisation (IVF)
url
https://www.hfea.gov.uk/treatments/explore-all-treatments/in-vitro-fertilisation-ivf/
kind
official
accessed at
2026-10-01
supports
IVF stages, laboratory fertilization, transfer and treatment risks.
limitations
UK regulator education; UK funding rules not generalized.
id
hfea-iui
title
Intrauterine insemination (IUI)
url
https://www.hfea.gov.uk/treatments/explore-all-treatments/intrauterine-insemination-iui
kind
official
accessed at
2026-10-01
supports
Prepared sperm placed in uterus; IUI and IVF differ in procedure and suitability.
limitations
The source retains legacy NICE wording; only its procedure explanation is used, not funding or referral rules.
id
cdc-art-notes
title
NASS Technical Notes
url
https://www.cdc.gov/art/php/nass/technical-notes.html
kind
official
accessed at
2026-10-01
supports
Cycle-, retrieval- and transfer-based rates; own/donor eggs; cumulative versus noncumulative reporting.
limitations
Surveillance definitions; clinic groups and reporting lag limit individual prediction.
id
cdc-art-rates
title
ART Success Rates
url
https://www.cdc.gov/art/success-rates/index.html
kind
official
accessed at
2026-10-01
supports
Official clinic-data access and IVF success estimator; estimates tied to patient characteristics.
limitations
Data-access landing page, not a review of individual clinics or current national numerical rates.
id
hfea-addons
title
Treatment add-ons with limited evidence
url
https://www.hfea.gov.uk/treatments/treatment-add-ons/?wp-linkindex=1
kind
official
accessed at
2026-10-01
supports
Optional extras; outcome/population-specific ratings; insufficient evidence differs from evidence of no benefit; page reviewed September 28, 2026.
limitations
UK regulator ratings; individual indications and safety require discussion; no universal ban inferred.
id
nichd-diagnosis
title
How is infertility diagnosed?
url
https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/diagnosed
kind
official
accessed at
2026-10-01
supports
History, ultrasound, HSG procedure and different structural tests.
limitations
General overview contains fixed-day progesterone language; ASRM individualized timing governs this article.
id
asrm-overview
title
Infertility: an Overview (booklet)
url
https://integration.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/infertility-an-overview-booklet/
kind
professional
accessed at
2026-10-01
supports
Types of specialists, records, histories, reducing repeated tests.
limitations
Patient booklet includes older practices; no unsupported success promise or obsolete reserve-test advice carried over.
id
lobo-evaluation
title
Basic Infertility Evaluation
url
https://www.reproductivefacts.org/browse-resources/videos/basic-infertility-evaluation-vid/
kind
professional
accessed at
2026-10-01
supports
Roger Lobo’s public teaching explains the core evaluation and specialist referrals.
limitations
Based on the transcript, not video review. Its egg-quality shorthand is qualified here using ASRM’s more precise ovarian-reserve opinion.
id
gameiro-profile
title
Dr Sofia Gameiro
url
https://profiles.cardiff.ac.uk/staff/gameiros
kind
professional
accessed at
2026-10-01
supports
Official role, patient-support tools, ESHRE psychosocial guideline contribution and research on treatment burden.
limitations
Role/research page, not proof that support improves live birth.
id
boivin-profile
title
Professor Jacky Boivin
url
https://profiles.cardiff.ac.uk/staff/boivin
kind
professional
accessed at
2026-10-01
supports
Official psychology role; fertility quality-of-life and coping-support work; public media role.
limitations
Role and contribution verification, not a medical treatment recommendation.
id
question-addons
title
Thoughts on the New Research on IVF Add-Ons??
url
https://www.reddit.com/r/IVF/comments/16zqzq6/thoughts_on_the_new_research_on_ivf_addons/
kind
question_signal
accessed at
2026-10-01
supports
Discussion illustrates confusion over PGT-A, per-transfer versus cumulative live birth and regulator ratings.
limitations
Community questions only; no anecdotes, statistics or recommendations used as factual authority.
id
nice-ng257
title
Fertility problems: assessment and treatment (NG257)
url
https://www.nice.org.uk/guidance/ng257
kind
guideline
accessed at
2026-10-01
supports
Published March 31, 2026, replacing CG156. The overview and initial-assessment chapter describe one-year assessment and earlier referral at 36 or known risk. Chapter 1.38 describes two years of trying before treatment, followed by discussion of stimulated IUI or IVF.
limitations
Only the cited chapters were reviewed. England-focused pathway, not U.S. insurance entitlement or an instruction to postpone evaluation.
id
nice-ui
title
Unexplained fertility problems in people trying to conceive through unprotected vaginal sexual intercourse
url
https://www.nice.org.uk/guidance/ng257/chapter/unexplained-fertility-problems-in-people-trying-to-conceive-through-unprotected-vaginal-sexual-intercourse
kind
guideline
accessed at
2026-10-01
supports
Recommendations 1.38.1–1.38.3: total two-year trying period before treatment; no standalone stimulation; consider up to four gonadotropin-stimulated IUI cycles or offer IVF after discussion.
limitations
Based on the official chapter, not the full guideline or local commissioning criteria.
id
asrm-pgta
title
The use of preimplantation genetic testing for aneuploidy: a committee opinion (2024)
url
https://www.asrm.org/practice-guidance/practice-committee-documents/the-use-of-preimplantation-genetic-testing-for-aneuploidy-a-committee-opinion-2024/
kind
guideline
accessed at
2026-10-01
supports
Routine PGT-A benefit for all IVF patients not demonstrated; trial populations and denominators matter; miscarriage benefit uncertain.
limitations
Subgroup benefit and values remain individual counseling questions; chromosome screening is not all genetic testing.
id
asrm-weight
title
Obesity and reproduction: a committee opinion (2021)
url
https://www.asrm.org/practice-guidance/practice-committee-documents/obesity-and-reproduction-a-committee-opinion-2021/
kind
guideline
accessed at
2026-10-01
supports
Weight-related associations, procedural safety, effects of weight-loss interventions on ovulation versus IVF/live birth and costs of delay.
limitations
Older opinion; weight is one contributor and care thresholds require individual safety assessment.
id
panel-cedars
title
Marcelle Cedars | UCSF Profiles
url
https://profiles.ucsf.edu/marcelle.cedars
kind
professional
accessed at
2026-10-01
supports
MD; UCSF professor of Obstetrics, Gynecology and Reproductive Sciences. Ovarian-aging research helps distinguish age, egg supply and treatment response. Public UCSF profile links ovarian-aging research, clinical care and institutional news for patients seeking context.
limitations
An investigator profile establishes expertise; it does not supply a personal pregnancy forecast.
id
panel-legro
title
Richard Legro | College of Medicine | Penn State
url
https://med.psu.edu/departments-faculty/directory/richard-legro
kind
professional
accessed at
2026-10-01
supports
MD; Penn State professor and chair; reproductive endocrinology and infertility specialist. Lead author of the randomized letrozole–clomiphene PCOS trial used here. NIH publicly explains his PCOS trial and its live-birth outcome.
limitations
Selected anovulatory-PCOS trial results cannot be generalized to all TTC.
id
panel-dokras
title
Anuja Dokras, MD, MHCI, PhD | Penn DBEI
url
https://dbei.med.upenn.edu/staff/anuja-dokras-md-mhci-phd/
kind
professional
accessed at
2026-10-01
supports
MD, MHCI, PhD; Penn professor and director of Penn PCOS Center. PCOS can require whole-health evaluation as well as an ovulation discussion. Official description of the multidisciplinary PCOS center shows reproductive, metabolic and psychological care in one pathway.
limitations
PCOS expertise does not establish that every irregular cycle or infertility problem is PCOS.
id
panel-schlegel
title
Dr. Schlegel Named Acting Chairman of Urology
url
https://news.weill.cornell.edu/news/2001/09/dr-schlegel-named-acting-chairman-of-urology
kind
professional
accessed at
2026-10-01
supports
MD; urologist and male-infertility researcher; Weill Cornell institutional biography and AUA/ASRM guideline contributor. Male evaluation, sperm retrieval and the interface with assisted reproduction. Institutional public explanation of male-factor treatment and professional guideline work make male assessment visible.
limitations
Biography is historical; no current leadership title or personal success probability claimed.
id
panel-pfeifer
title
Samantha M. Pfeifer, M.D. | Patient Care
url
https://weillcornell.org/spfeifer
kind
professional
accessed at
2026-10-01
supports
MD; board-certified reproductive endocrinologist; Weill Cornell professor of clinical reproductive medicine. Uterine-anomaly classification and reproductive surgery illustrate why structural findings need specific interpretation. Official bio documents provider/patient MAC2021 educational tool and frequent professional teaching.
limitations
Surgical expertise does not imply surgery improves every infertility outcome.
id
panel-gracia
title
Clarisa R. Gracia, MD, MSCE | Penn Medicine
url
https://www.pennmedicine.org/providers/clarisa-gracia
kind
professional
accessed at
2026-10-01
supports
MD, MSCE; Penn reproductive endocrinologist, division chief and fertility-preservation director. Connects medical history, reproductive aging and an inclusive assessment pathway. Patient-facing profile explains fertility-preservation and reproductive-aging interests; named contributor to ASRM's 2023 definition.
limitations
Fertility-preservation decisions require individual medical risks and timing; no preservation guarantee.
id
panel-falcone
title
Tommaso Falcone, MD | Cleveland Clinic
url
https://providers.clevelandclinic.org/provider/tommaso-falcone/4270552
kind
professional
accessed at
2026-10-01
supports
MD; reproductive endocrinology-trained Cleveland Clinic physician and professor. Structural disease and minimally invasive reproductive surgery inform questions about indications and alternatives. Official provider biography, education and public provider-video link explain his reproductive and surgical scope.
limitations
Provider biography establishes the clinical field, not treatment outcomes.
id
panel-van-voorhis
title
2019 Award for Achievement: Bradley Van Voorhis, MD
url
https://alumni.medicine.uiowa.edu/news/2020/03/2019-award-achievement-bradley-van-voorhis-md
kind
professional
accessed at
2026-10-01
supports
MD; University of Iowa reproductive endocrinologist and IVF safety researcher. Single embryo transfer can reduce multiple-birth burden; outcome literacy includes safety as well as pregnancy. University's public feature explains his single-embryo-transfer work and why IVF safety matters.
limitations
2020 feature verifies contribution; its administrative title is not claimed current.
id
panel-fauser
title
Catalogus professorum | Fauser B.C.J.M.
url
https://profs.library.uu.nl/hoogleraar/fauser-b-c-j-m/
kind
professional
accessed at
2026-10-01
supports
MD, PhD; Utrecht professor emeritus of reproductive medicine. Ovarian-response and AMH scholarship helps separate biological measures from broad fertility predictions. Public university record documents reproductive-medicine scholarship and retirement lecture; Glasgow lists his AMH collaboration with Nelson.
limitations
Retired Utrecht appointment; the profile does not establish a present clinic role or findings from every listed paper.
id
panel-nelson
title
Professor Scott Nelson | University of Glasgow
url
https://www.gla.ac.uk/schools/medicine/staff/scottnelson/
kind
professional
accessed at
2026-10-01
supports
Professor; Muirhead Chair of Reproductive and Maternal Medicine, University of Glasgow. AMH biomarker research and quantitative prediction support careful measurement literacy. Public faculty page lists fertility research and AMH interpretation papers, giving a route to specialist evidence.
limitations
Publication listing verifies contribution; it does not mean every listed paper was read.
id
panel-teede
title
Helena Teede | Monash University
url
https://research.monash.edu/en/persons/helena-teede/
kind
professional
accessed at
2026-10-01
supports
MBBS, PhD, FRACP; Monash professor and Monash Health endocrinologist. 2023 PCOS guideline specifies the population for first-line letrozole and wider health assessment. Official biography verifies community involvement, patient resources and media education; led international PCOS guideline synthesis.
limitations
Guideline recommendations have eligibility limits; no individual prescription is offered.
id
panel-lobo
title
Rogerio Arnaldo Lobo, MD | Obstetrics & Gynecology
url
https://www.obgyn.columbia.edu/profile/rogerio-lobo-md
kind
professional
accessed at
2026-10-01
supports
MD; Columbia professor of Obstetrics and Gynecology and reproductive endocrinology fellowship director. Explains how ovulation, semen and uterine/tubal evaluation fit together and which specialists help. ASRM’s Basic Infertility Evaluation transcript offers patient-facing teaching.
limitations
Ovarian reserve concerns egg supply and response; this teaching should be read with ASRM’s distinction between egg quantity and quality.
id
panel-eisenberg
title
People | Eisenberg Lab | Stanford Medicine
url
https://med.stanford.edu/eisenberglab/People.html
kind
professional
accessed at
2026-10-01
supports
MD; Stanford urologic surgeon-scientist and male reproductive medicine program leader. Male fertility and general-health research supports including reproductive urology in the workup. Public lab biography and institutional care-team pages explain specialist male-infertility care.
limitations
Experimental work listed by the lab is not an endorsed add-on or established treatment.

professional panel

name
Marcelle Cedars
credential
MD; UCSF professor of Obstetrics, Gynecology and Reproductive Sciences
official url
https://profiles.ucsf.edu/marcelle.cedars
public usefulness
Public UCSF profile links ovarian-aging research, clinical care and institutional news for patients seeking context.
contribution
Ovarian-aging research helps distinguish age, egg supply and treatment response.
boundary
An investigator profile establishes expertise; it does not supply a personal pregnancy forecast.
reviewed at
2026-10-01
name
Richard Legro
credential
MD; Penn State professor and chair; reproductive endocrinology and infertility specialist
official url
https://med.psu.edu/departments-faculty/directory/richard-legro
public usefulness
NIH publicly explains his PCOS trial and its live-birth outcome.
contribution
Lead author of the randomized letrozole–clomiphene PCOS trial used here.
boundary
Selected anovulatory-PCOS trial results cannot be generalized to all TTC.
reviewed at
2026-10-01
name
Anuja Dokras
credential
MD, MHCI, PhD; Penn professor and director of Penn PCOS Center
official url
https://dbei.med.upenn.edu/staff/anuja-dokras-md-mhci-phd/
public usefulness
Official description of the multidisciplinary PCOS center shows reproductive, metabolic and psychological care in one pathway.
contribution
PCOS can require whole-health evaluation as well as an ovulation discussion.
boundary
PCOS expertise does not establish that every irregular cycle or infertility problem is PCOS.
reviewed at
2026-10-01
name
Peter Schlegel
credential
MD; urologist and male-infertility researcher; Weill Cornell institutional biography and AUA/ASRM guideline contributor
official url
https://news.weill.cornell.edu/news/2001/09/dr-schlegel-named-acting-chairman-of-urology
public usefulness
Institutional public explanation of male-factor treatment and professional guideline work make male assessment visible.
contribution
Male evaluation, sperm retrieval and the interface with assisted reproduction.
boundary
Biography is historical; no current leadership title or personal success probability claimed.
reviewed at
2026-10-01
name
Samantha Pfeifer
credential
MD; board-certified reproductive endocrinologist; Weill Cornell professor of clinical reproductive medicine
official url
https://weillcornell.org/spfeifer
public usefulness
Official bio documents provider/patient MAC2021 educational tool and frequent professional teaching.
contribution
Uterine-anomaly classification and reproductive surgery illustrate why structural findings need specific interpretation.
boundary
Surgical expertise does not imply surgery improves every infertility outcome.
reviewed at
2026-10-01
name
Clarisa Gracia
credential
MD, MSCE; Penn reproductive endocrinologist, division chief and fertility-preservation director
official url
https://www.pennmedicine.org/providers/clarisa-gracia
public usefulness
Patient-facing profile explains fertility-preservation and reproductive-aging interests; named contributor to ASRM's 2023 definition.
contribution
Connects medical history, reproductive aging and an inclusive assessment pathway.
boundary
Fertility-preservation decisions require individual medical risks and timing; no preservation guarantee.
reviewed at
2026-10-01
name
Tommaso Falcone
credential
MD; reproductive endocrinology-trained Cleveland Clinic physician and professor
official url
https://providers.clevelandclinic.org/provider/tommaso-falcone/4270552
public usefulness
Official provider biography, education and public provider-video link explain his reproductive and surgical scope.
contribution
Structural disease and minimally invasive reproductive surgery inform questions about indications and alternatives.
boundary
Provider biography establishes the clinical field, not treatment outcomes.
reviewed at
2026-10-01
name
Bradley Van Voorhis
credential
MD; University of Iowa reproductive endocrinologist and IVF safety researcher
official url
https://alumni.medicine.uiowa.edu/news/2020/03/2019-award-achievement-bradley-van-voorhis-md
public usefulness
University's public feature explains his single-embryo-transfer work and why IVF safety matters.
contribution
Single embryo transfer can reduce multiple-birth burden; outcome literacy includes safety as well as pregnancy.
boundary
2020 feature verifies contribution; its administrative title is not claimed current.
reviewed at
2026-10-01
name
Bart Fauser
credential
MD, PhD; Utrecht professor emeritus of reproductive medicine
official url
https://profs.library.uu.nl/hoogleraar/fauser-b-c-j-m/
public usefulness
Public university record documents reproductive-medicine scholarship and retirement lecture; Glasgow lists his AMH collaboration with Nelson.
contribution
Ovarian-response and AMH scholarship helps separate biological measures from broad fertility predictions.
boundary
Retired Utrecht appointment; the profile does not establish a present clinic role or findings from every listed paper.
reviewed at
2026-10-01
name
Scott Nelson
credential
Professor; Muirhead Chair of Reproductive and Maternal Medicine, University of Glasgow
official url
https://www.gla.ac.uk/schools/medicine/staff/scottnelson/
public usefulness
Public faculty page lists fertility research and AMH interpretation papers, giving a route to specialist evidence.
contribution
AMH biomarker research and quantitative prediction support careful measurement literacy.
boundary
Publication listing verifies contribution; it does not mean every listed paper was read.
reviewed at
2026-10-01
name
Helena Teede
credential
MBBS, PhD, FRACP; Monash professor and Monash Health endocrinologist
official url
https://research.monash.edu/en/persons/helena-teede/
public usefulness
Official biography verifies community involvement, patient resources and media education; led international PCOS guideline synthesis.
contribution
2023 PCOS guideline specifies the population for first-line letrozole and wider health assessment.
boundary
Guideline recommendations have eligibility limits; no individual prescription is offered.
reviewed at
2026-10-01
name
Rogerio (Roger) Lobo
credential
MD; Columbia professor of Obstetrics and Gynecology and reproductive endocrinology fellowship director
official url
https://www.obgyn.columbia.edu/profile/rogerio-lobo-md
public usefulness
ASRM's opened Basic Infertility Evaluation transcript is a direct public teaching resource.
contribution
Explains how ovulation, semen and uterine/tubal evaluation fit together and which specialists help.
boundary
Ovarian reserve concerns egg supply and response; this teaching should be read with ASRM’s distinction between egg quantity and quality.
reviewed at
2026-10-01
name
Jacky Boivin
credential
PhD; Cardiff professor and Chair in the School of Psychology
official url
https://profiles.cardiff.ac.uk/staff/boivin
public usefulness
Official profile identifies media commentary and tools supporting people trying to conceive, including fertility quality-of-life work.
contribution
Psychosocial research keeps emotional burden and accessible support inside fertility care.
boundary
Support is valuable for well-being; it is not a proven fertility cure.
reviewed at
2026-10-01
name
Sofia Gameiro
credential
PhD in health psychology; Cardiff Reader in the School of Psychology
official url
https://profiles.cardiff.ac.uk/staff/gameiros
public usefulness
Official profile links patient-support tools and ESHRE psychosocial-care guidance she co-developed.
contribution
Research on treatment burden, care preferences and continuation/discontinuation informs review-point discussions.
boundary
Psychological research does not determine the biological cause or prescribe a treatment sequence.
reviewed at
2026-10-01
name
Michael Eisenberg
credential
MD; Stanford urologic surgeon-scientist and male reproductive medicine program leader
official url
https://med.stanford.edu/eisenberglab/People.html
public usefulness
Public lab biography and institutional care-team pages explain specialist male-infertility care.
contribution
Male fertility and general-health research supports including reproductive urology in the workup.
boundary
Experimental work listed by the lab is not an endorsed add-on or established treatment.
reviewed at
2026-10-01

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End of Infertility / TTC