You've been trying

'Infertility' is a clinical threshold, not a verdict: twelve months under 35, six months at 35 and over. Reaching it means you qualify for an evaluation.

An initial evaluation looks at three things: whether you're ovulating, whether the uterus and tubes are normal, and semen quality. Most fits in one cycle.

You can start with your OB-GYN or go directly to a reproductive endocrinologist. Both partners should be evaluated at the same time.

• Strong evidence Cover your fertile window. Sex every one to two days through the five days before ovulation and the day itself. Timing, simply.
• Strong evidence Keep taking your prenatal. Every day, including the months it doesn't happen.
• Strong evidence Both of you: no smoking, and keep alcohol and caffeine low. No alcohol for you while trying; caffeine under about 200 mg.
• Emerging evidence Eat in a Mediterranean pattern. Good for your health, and linked to fewer ovulation problems. What it looks like, and food safety.
• Your partner: keep cool. Loose underwear and no hot tubs while trying. If it's been a while, a semen analysis is quick and simple.

• Whether the timing has really been covered

  Worth ruling out before anything else, because it's the most common fixable thing. Most people are aiming at a narrower window than they think, and waiting for a positive LH test means starting four days late. How to know when you ovulate → · How often to try →
• Ovulation

  Regular cycles usually mean you're ovulating. If cycles are irregular, a progesterone level drawn in the second half of the cycle — about a week before your next period is due, which is roughly seven days after you ovulate — can confirm it. Timing is the whole point of that test: drawn mid-cycle it tells you almost nothing.
• Ovarian reserve

  AMH (any cycle day), antral follicle count by ultrasound, or day 2–4 FSH and estradiol. These estimate egg quantity, not quality, and a low result doesn't mean you can't conceive.
• Uterus and tubes

  A transvaginal ultrasound plus an HSG (X-ray with dye) to check whether the tubes are open. A saline sonogram checks the cavity only, unless it's done with contrast (HyCoSy).
• Semen analysis

  For your partner, at the start, not after everything else comes back normal.
• Thyroid

  TSH is commonly checked as part of an infertility evaluation; ask whether it's included.

• Given my age and how long we've been trying, do you agree it's time for an evaluation?
  Under 35, guidelines suggest an evaluation after twelve months of trying, or sooner if there's a known reason to (irregular cycles, a history of pelvic infection or surgery, endometriosis, or a partner with a known issue).
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• What does a complete initial evaluation include here, and can we do all of it in one cycle?
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• Has my partner had a semen analysis? If not, can we order one now?
  Male factors contribute in roughly 40–50% of cases, and the test is simple. It's the most commonly skipped part of an evaluation.
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• Should I see a reproductive endocrinologist now, or is this something your office does fully?
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Plus 2 more on your appointment checklist.

The evaluation usually takes one to two cycles. Once it's underway, move to I'm getting a workup to understand what each test is looking for.

The results that most often decide the next step: whether you're ovulating, whether the tubes are open, your ovarian reserve range, and the semen analysis.

If all of those come back normal, the next conversation is usually about 'unexplained infertility' and the options for it. That's a plan, not a dead end.

It's reasonable to seek another opinion if you meet the guideline threshold and are told to keep trying without any evaluation; if your partner isn't being tested; or if you're offered treatment before a basic evaluation is done. Bring your cycle history and any results. See I want a second opinion.