January 16, 2017 Liza Colimon, MD As I have been in the trenches caring for and educating women, a common question I encounter on a weekly basis sounds something like this, "Doctor, I'm 35 years old, single, and have never been pregnant. Should I be worried about Infertility? Is there anything I can do?" Chances are, the answer is No. Especially if you have not been actively trying to get pregnant. Infertility by definition involves a couple, not a single individual. Likewise questions regarding fertility can be tough to provide generalizable answers. If you are a healthy women without any history of sexually transmitted diseases such as chlamydia that can cause scarring and damage in the fallopian tubes, have never had surgery involving your fallopian tubes, and have regular monthly periods, you likely have little to worry about other than timing... AND finding "Mr. Right." Having a regular period is key to letting you know that you are ovulating on a monthly basis. If you have irregular periods you may need some help becoming pregnant from a specialist once you do commit to starting a family. Endometriosis and scarring or damage to your cervix can also put you at risk for infertility and it is important to let your doctor know. Many women over the age of 35 become pregnant without needing fertility treatments. For some women, getting pregnant as we mature may take more time do to the quality of our eggs as we age. Studies have found the frequency of primary infertility in married women ages 35-44 can range from 25-30% compared to 9% of women in their 20's and 30's. Medical studies have also found that on average it may take 80 out of 100 couples up to 12 months before they actually conceive. The true definition of infertility is the inability to conceive a pregnancy after 12 months of having regular unprotected intercourse. Male factor infertility can be the culprit in over 40% of cases. So before committing to any invasive testing, it's important for women to encourage their partners to have a semen analysis and testicular exam FIRST if you have not become pregnant after a full year of actively trying. It is recommended you seek help if you are over the age of 35 and have not conceived in 6 months. Initiating any testing before you have actually been diagnosed with infertility is not recommended as you may be putting the cart before the horse! Bottom line, if you haven't been trying to get pregnant, then you cannot be sure you will actually have any problems. Freezing eggs is typically not recommended. Some families choose to freeze embryos, which are eggs that have already been fertilized by sperm, if there are major health concerns or medical treatments planned that will cause sterility. If you describe yourself as 35 years young and healthy, the best thing you can do is eat a well balanced diet, exercise, maintain an ideal body weight, and be proactive in you personal life. I've often told my girlfriends you have to be as goal-orientated in your personal life as you are in your professional life! If you have a partner and have been actively trying to get pregnant without success after six months, do not be afraid to seek help. You should not feel alone nor enter any infertility evaluation without your partner. Working together should be an essential part of your medical evaluation process! Remember... a diagnosis of Infertility involves a couple, not an individual.