Your TTC Strategy 10: Determine Whether Early Infertility Evaluation Is Right for You

by Deborah Metzger, MD

  • Severe menstrual cramps, pain with intercourse, or pain with bowel movements may indicate endometriosis. Surgery to remove the endometriosis can improve fertility. Likewise, a woman who has been previously diagnosed with endometriosis should see a fertility specialist before trying to conceive.


  • Heavy menstrual periods, that is, having to change a tampon or pad more often than every two hours, could indicate an endometrial polyp, fibroids, or hormonal imbalance that could interfere with implantation. (Fibroids can interfere with implantation or increase the risk of premature delivery.


  • Women born with a single kidney may also have reproductive tract abnormalities.


  • Excessively oily skin or hirsutism (extra body hair) or a diagnosis of polycystic ovarian syndrome (PCOS) calls for early evaluation. These problems are associated with hormonal imbalances and an increased risk of fertility problems and miscarriage.


  • If a woman's mother took DES when she was pregnant with her, she may have uterine abnormalities that can affect her ability to carry a child.

  • Breast discharge, particularly if it is milky in appearance, can indicate an overproduction of prolactin.


  • Women who have had a prior tubal sterilization reversal have an increased risk of ectopic pregnancy and should be evaluated.


  • Prior chemotherapy or radiation for cancer may alter ovarian egg reserve.


  • Family history of cystic fibrosis or other genetic abnormality should be evaluated. There are methods available to decrease the risk of passing on these genes to offspring.


  • History of a pituitary tumor may cause a hormonal imbalance.


  • Major medical problems such as autoimmune diseases, heart disease, organ transplant, or Graves' disease, should be completely investigated in terms of fertility signs.

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