When Should I See a Fertility Specialist?
Quick Answer
You should see a fertility specialist if you are under 35 and have been trying to conceive for 12 months without success, or over 35 and have been trying for 6 months. If you are over 40, have a known condition affecting fertility, or are planning to use donor gametes, consulting a specialist right away is recommended.
Markham Fertility Centre offers consultations across five Ontario locations with a team of five reproductive endocrinologists.
General Timeline by Age
| Your age | When to see a specialist |
| Under 35 | After 12 months of regular, unprotected intercourse without pregnancy |
| 35 to 39 | After 6 months of trying |
| 40 and older | As soon as you are ready to start trying |
These timelines exist because fertility declines with age. A healthy 30-year-old has a roughly 18% chance of conceiving each cycle. By age 40, that drops to around 7%% and below 2% over 45. Egg quality and quantity decrease significantly after 35, and the risk of miscarriage rises in parallel.
Signs You Should See a Specialist Sooner
Regardless of how long you have been trying, certain symptoms and histories warrant an earlier consultation:
Menstrual cycle concerns:
- Irregular periods (shorter than 21 days or longer than 35 days)
- Absent periods for several months
- Very heavy periods or severe menstrual pain (a common sign of endometriosis)
Known medical conditions:
- PCOS, endometriosis, uterine fibroids, or thyroid disorders
- History of pelvic inflammatory disease or STIs
- A cancer diagnosis or upcoming treatment that may affect fertility
Pregnancy history:
- Two or more miscarriages (recurrent pregnancy loss)
- Previous ectopic pregnancy or pelvic surgery
Male factor concerns:
- Known low sperm count, poor motility, or ejaculatory difficulties
- History of testicular trauma, surgery, or cancer treatment
If any of these apply to you or your partner, do not wait for the standard timeline.
You Do Not Need to Be “Trying to Conceive (TTC)” in order to see a fertility See a Specialist
Fertility specialists are not only for couples struggling to conceive. You should also consider a consultation if:
- You are a single individual planning to conceive with donor sperm
- You are in a same-sex couple and need guidance on donor gametes, IUI, IVF, or surrogacy
- You want to freeze your eggs or sperm for future family planning
- You have received a cancer diagnosis and want to preserve fertility before treatment
- You simply want a baseline fertility assessment to understand your reproductive health
In Ontario, initial consultations and most diagnostic assessments are covered by OHIP, making it accessible to explore your options without significant upfront cost.
What Happens at a First Fertility Consultation
A typical initial consultation includes:
- Medical history review: Menstrual cycles, pregnancy history, sexual health, lifestyle, and relevant conditions for both partners
- Diagnostic testing: Hormone blood work (AMH, FSH, estradiol, TSH), transvaginal ultrasound, and semen analysis
- Discussion of goals: Your timeline, family-building goals, and concerns
- Preliminary plan: Further testing if needed (such as a hysterosalpingogram to check fallopian tubes) or initial treatment options
At Markham Fertility Centre, the first appointment is with one of five reproductive endocrinologists who remains your physician throughout the process, ensuring continuity and personalized care. Each physician also has a team of nurses and administrative staff who get to know you and are familiar with your journey. There is nothing more frustrating than meeting new people every visit and having to repeat yourself over and over again.
What a Fertility Specialist Can Do
A reproductive endocrinologist is an OB-GYN with additional fellowship training in hormonal function and reproductive medicine. They are qualified to:
- Diagnose the cause of infertility through comprehensive testing
- Treat ovulatory disorders with medication
- Perform or oversee IUI and IVF procedures
- Manage recurrent pregnancy loss and implantation failure
- Coordinate donor and surrogacy programs
- Provide genetic counselling and preimplantation genetic testing
- Preserve fertility through egg, sperm, or embryo freezing
This goes beyond what a general OB-GYN can offer, particularly for complex cases or when time is a factor.
Fertility Care Access in Ontario
Ontario residents benefit from strong public support:
- Initial consultations and diagnostic testing covered by OHIP
- Funded IUI cycles through the Ontario Fertility Program (OFP) with no lifetime limit
- One funded IVF cycle per lifetime for eligible patients under 43
- Funded fertility preservation for patients with a medical indication (e.g. cancer)
- Fertility Treatment Tax Credit (effective January 2025): 25% of eligible expenses up to $5,000/year
Most clinics require a referral from your family physician, though some accept self-referrals.
Why Patients in Ontario Choose Markham Fertility Centre
- Five experienced reproductive endocrinologists providing physician-led care from consultation through pregnancy
- Five clinic locations across Markham, Barrie-Innisfil, Oshawa, Orillia, and Sudbury
- Expertise in complex cases including recurrent pregnancy loss, implantation failure, and reproductive immunology
- Dedicated Donor and Surrogacy team providing Inclusive care for 2SLGBTQIA+ individuals, single parents by choice, and those using donor gametes
- Comprehensive genetics program
- Ability to manage medically complex cases as the only clinic that routinely provides anaesthesiology-assisted egg retrievals for a pain free and safe retreival
Book a consultation at Markham Fertility Centre →
FAQ
Do I need a referral to see a fertility specialist in Ontario?
Most clinics require a referral from your family physician or OB-GYN. Some also accept self-referrals. Markham Fertility Centre requires a referral. Once referred, the clinic will contact you to schedule your initial consultation.
Is a fertility consultation covered by OHIP?
Yes. Initial consultations and most diagnostic testing are covered for Ontario residents with a valid health card.
Can I see a fertility specialist if I am single?
Absolutely. Fertility specialists work with single individuals who want to conceive using donor sperm or preserve their fertility. At Markham Fertility Centre, the Donor and Surrogacy team provides full support for single patients.
Should I see my OB-GYN or go directly to a fertility specialist?
If you meet the age-based timelines above or suspect a fertility issue, going directly to a reproductive endocrinologist saves time. A fertility specialist offers the full range of diagnostic tools and advanced treatments that a general OB-GYN cannot. You can obtain a referral from a walk-in clinic or your family doctor.