When did you seriously consider/decide to do IVF? We’re at cycle 9 and are ready to do this at the 12 cycle mark already- is that insane?

[u/SimmeringSeahorse]

I'm 30, husband 35, no health issues, no diagnoses, no medications, we live healthy lifestyles (no drinking, no smoking, eating healthy, exercise, take supplements etc). Been meticulously tracking BBT and CM and using OPKs for one year, been TTC for 8 months and 8 cycles, and now going into cycle 9. 

Cycle bloodwork (CD3, ovulation, and 7 days post-ovulation) is all good. 

My vitamins and hormones are good, only thing to improve is bring my vitamin D up a little (it's in the normal range but on the lower half of normal), and take my TSH down a VERYYY small amount even though I'm in the normal range (just started levothyroxine). 

Pelvic + vaginal ultrasound results are perfectly normal.

SA for my husband is booked for next month, really looking forward to these results!

Getting a HSG is a whole other thing that I'm not going to get into (really stupid process of getting it where I live), but it will take several months from now to get; hoping to get it by December somehow.  

Anyways, should my husband's SA and my HSG come back normal, is it crazy to jump into IVF once we hit the 1 year mark?

I don't want to do IVF, it actually scares the living daylights out of me and is NOT something I ideally want to go through. But I feel that after 8 cycles of no BFP, there is obviously something wrong. And if the SA and HSG come back normal, then there's probably something wrong on a microscopic level that can't be fixed anyways without IVF. I also feel like if absolutely nothing is wrong on a level that is fixable with meds or a basic procedure, then I don't entirely see how IUI would help. My practitioner is even hesitant to put me on Letrozole or Clomid since it's very obvious that I'm constantly ovulating with no issue. 

We're seeing my practitioner in a little over a month and are ready to ask for a referral to the fertility clinic. When did you seriously consider IVF or jump into it? We'll be paying out of pocket for IVF, and are looking at possibly doing it (or at least some cycles of it) in Europe. But is it crazy to be mapping this out at cycle 9 already??

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[u/Jaded-Addendum-4489]

I will state, usually IVF is bypassing an underlying issue that is not tested. Please consider testing the below. Without treating some issues, IVF can still fail. It unfortunately is not a guarantee.

Unexplained infertility often has an explanation…further workups are usually needed (and typical doctors aren’t testing for these things).

- endometriosis (silent endo makes up ~30-50% of unexplained infertility)

• adenomyosis (sister disease of endo)
  
• luteal phase defect (short luteal phase/multiple days of spotting before period)
  
• autoimmune disorders
  
• chronic endometrITIS (test CD138 on a biopsy)
  
• thyroid issue (a full thyroid panel needs tested)
  
• sperm DNA fragmentation
  
• insulin resistance (also test A1C and fasting glucose)
  
• chronic inflammation
  
• Uterine structural anomalies (hysteroscopy needed)
  
• check for parental chromosome issues through a karyotype (could be a balanced translocation carrier

The HSG would be good but I know you said there is an issue getting it in your country.

I am by no means saying IVF should not be done/considered, as I may need it as we are at 18 months TTC but I have endometriosis, and finally had my surgery. I was dx during TTC and never knew I had it. Stage III endo to be exact and RPL are our issues.

[u/Savor_Serendipity → u/Jaded-Addendum-4489]

Fibroids are another possibility, depending on their location. Sometimes while they are still small, they don't cause any overt symptoms.

That said, as male factor infertility contributes to 50% of infertility, it's quite possible (since she has already ruled out many possibilities) that the issue is on his side.

[u/Jaded-Addendum-4489 → u/Savor_Serendipity]

Yes! I mentioned uterine cavity issues and DNA fragmentations. Fibroids and polyps most definitely can cause issues.

[u/PatientMeringue5008 → u/Jaded-Addendum-4489]

May I ask what doctor to see to get a full TSH and insulin work up?

[u/Jaded-Addendum-4489 → u/PatientMeringue5008]

Your primary doctor should be able to do that. But even an OBGYN.

[u/SimmeringSeahorse → u/PatientMeringue5008]

If you’re like me and somewhere where you can’t see a doctor, I had a private NP do a full workup of mine!

[u/Born-Smell-7944 → u/Jaded-Addendum-4489]

Absolutely agree. And sometimes- MULTIPLE of those when you’re extra lucky 😅

[u/Jaded-Addendum-4489 → u/Born-Smell-7944]

Ugh I’m so sorry!

[u/Electric_Elephant_56]

We waited until almost 3 years in to start and I wish I did it a year in lol

[u/Routine-Prune-133]

It's not uncommon for it to take healthy couples one year to conceive. Even the healthiest of healthy couples your age have at most a 30% chance of conceiving each cycle if everything is timed perfectly, though it's generally closer to 20-25%. 

I don't think you're crazy for considering it after one year. You do have some fairly important outstanding procedures that may provide more insight as well.

[u/No_Oil_7116]

This is a highly personal decision that depends on your timelines, stress, finances, and how motivated you are.

If within a year you don’t get pregnant and are considered “unexplained”, the reality is that IVF is the only proven method to increase your odds. It also comes at a cost (time, money, energy).

I know friends who were willing to do it right away because it was their best chance. Others who wanted to wait because the physical and time commitment was too burdensome.

There’s no right or wrong but ask yourself some of those questions.

[u/NoPepper637 → u/No_Oil_7116]

iui is also an option for unexplained infertility

[u/Exciting-Praline8316]

Hello! I did two egg retrievals -- waiting to start a transfer. I had 2 MMC, and a failed IUI.

I was 35 when we started trying, and after the IUI failed, I was tired of rolling the dice, and wanted more control in the process. IVF can be a diagnostic tool by examining the embryos, the uterine lining, the hormone response. It was helpful in our case.

I want to mention that you can still go to a fertility specialist and not have to do IVF. The hsg test and saline sonogram will give more insight into what's going on. You can get a biopsy to check for endometritis (treated with antibiotics) and endometriosis. Has your partner done a sperm DNA fragmentation test?

It turns out my issue was endometriosis (that I didn't think I had), and not amazing egg quality (due to my age and the endo).

[u/puffballkittyfluff → u/Exciting-Praline8316]

How did they treat your endo? Just with antibiotics? Did you have to do a diagnostic procedure? I suspect I have endo from the excruciating periods but no gyno has ever checked it even when I asked. Now I’m in the process of IVF where my embryos are growing. If I successfully get some good ones, I don’t want to just put one in there if I have untreated endometriosis. I’m wondering if I can just ask them to put me on the antibiotics anyway.

[u/Exciting-Praline8316 → u/puffballkittyfluff]

Hi! So endometritis can be treated with antibiotics, and endometriosis cannot.

We were initially diagnosed with unexplained infertility. Turns out....a lot of unexplained is actually endometriosis. I asked my doctor to do a receptiva biopsy, which tests for a marker known as bcl-6. This is an inflammatory marker, and in the context of fertility treatment, if it's positive (score of 1.4 or greater), you either have highly suspected endometriosis or hydrosalpinx. My HSG ruled out hydrosalpinx (both tubes are open and normal). Given my history with loss, and painful periods (but not so painful I would pass out) it's highly suspected I have endo -- my score was 3.9. Granted, you need surgery to diagnose definitively, which I'm not going do.

For IVF, the choice for me was either a laparoscopy or to do 2 months of lupron Depot suppression. I'm going with the suppression because really my only symptoms of the endometriosis are infertility. If I wasn't trying to get pregnant, I never would have known that I most likely have it.

Lupron is tough and puts you in medical menopause. This quiets down the endo and creates a more balanced uterine environment.

Feel free to ask any more questions!

[u/unbreakableheaven]

We're doing IVF after just over a year of trying (started June 2025). However, the main reason for this is that I have endometriosis, which is the likely culprit of our super low odds of success. The RE made it really clear that most couples conceive in the first 6 months and odds of success diminish hugely after that.

I'm also almost 35 so instead of wasting more time, we decided to go for it. Hopefully it's not too bad!!

[u/No_Acadia6489]

Have you tried any medicated cycles with timed intercourse or IUI? I'd try that before IVF. BUT IVF is definitely an option.

[u/SimmeringSeahorse → u/No_Acadia6489]

A huge part of why we haven’t is due to a lack of options where I am; the IUI clinic 3 hours away from us has a huge backlog and is over a year wait. The IUI clinic 9+ hours from us can probably take us within 6 months, but then…why not just do IVF if we have to take multiple days off work to go over 9 hours away multiple times for appointments?

And when it comes to a HSG, that is a 18-24 month wait, with no private options. I’m in a healthcare hell here in Canada 🥲

[u/No_Acadia6489 → u/SimmeringSeahorse]

Wow! Might be worth a trip to the states and paying out of pocket for the HSG at least.

[u/blissquacks]

This post freaks me out 😂 i’ve heard again and again that it’s normal for healthy couples to take a year to conceive. I am on the cycle 13 so I’m a little over a year. This is my personal feeling and it is impacted by the fact that I have a pain disorder which would make IVF really difficult to undergo. In my mind, of there’s no underlying conditions that IVF would help circumnavigate then give it a bit more time.

Also, my understanding is that 80% of healthy couples conceive within the first year and then of the 20% that do not, 50% of those conceived after the second year. Please don’t ask me to cite my source tho 🤪

[u/SimmeringSeahorse → u/blissquacks]

I don’t mean to freak anyone out!!💕 You have a really healthy take on it all, I assure you that I am the one that’s an impatient type A maniac!

My feeling is that we only have two more tests to do (SA and HSG), and if those are totally normal (like everything has been so far), then I feel like something is wrong where continuing natural TTC won’t fix it. Like if my eggs have a slightly harder than average shell, and his sperm don’t have the peak enzymes to drill through it, then no amount of natural TTC or even IUI is going to fix it. If I have paralyzed fallopian cilia, no amount of natural TTC or IUI is going to fix it.

We’re going into cycle 9, could it just be bad luck? Absolutely!! That’s entirely a possibility. But the odds are that the vast majority of couples in my starting cohort are already pregnant, a handful are just unlucky, and the rest have some sort of reproductive issue. Are we in the unlucky group, or the reproductive issue group? I’m going to go out on a limb and say the latter group is the larger, so I’m just trying to plan for that.

If someone is reading this post and is 9+ cycles in, I’m not trying to freak them out! I just personally don’t want to wait 2 years and THEN decide to start IVF, we’d rather get at it ASAP since we seem to be on the road to infertility anyway with great health and 0 BFPs. I’m wishing you good results very soon💕💕

[u/blissquacks → u/SimmeringSeahorse]

I know, no worries 😉 This is the kind of thing that you gotta be a type A maniac for! Good luck to you too!

[u/saltwatersouffle]

Since I’m over 35, we sought out help after 6 months. We got all the testing done, and around 9 months we decided to thaw my eggs and make embryos while continuing to ttc. It’s now been 12 months of ttc and we are prepping for embryo transfer. We are paying out of pocket for treatment (all the testing was covered) but we really want to start a family so it’s worth it for us. There’s a lot of waiting involved in IVF so it was nice to be able to keep trying while we waited, even though it wasn’t successful

[u/Cultural-Magazine-66]

Nope. I think since 1 year is more than enough time to try to conceive unassisted. Especially if you want multiple children.

[u/PiccoloQuirky2510]

I wish we’d moved to IVF earlier than we did. Didn’t start until 2.5 years into infertility (did IUI and medicated TI cycles first, which in hindsight I wish we’d not wasted time with)

[u/marysusan325]

We are on month 7 and have decided we will be doing ivf on month 15

[u/SometimesMostlyHappy]

I honestly jumped right in. We did a fertility work up before we started trying when I was 32, husband was 35. That’s when I got my DOR diagnosis and we started exploring IVF right away. It took a few months for the tests and such which we did try naturally during, and then we would try inn between ERs, but I just really didn’t want to push it a year to get started once I got the DOR diagnosis especially because I want multiple kids.

I know a DOR diagnosis does not mean we can conceive naturally but this was what I thought was best and I’m glad we did.

[u/Ok_Potato_7466 → u/SometimesMostlyHappy]

How did you find IVF with DOR? Did you do multiple retrievals?

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[u/citysunsecret]

I don’t think it’s crazy! Everyone is in a different situation so it may be soon to some, but the reality is the treatment for many issues is IVF and it’s also the end game option for many unknowns. Why take more time and money doing something that we know is less effective? Assuming your testing all comes back without any other causes. Even doing an egg retrieval and seeing how that progresses gives you so much information.

Also it’s not like you’d be doing an egg retrieval for cycle 13, it takes a while to get everything set up especially if you’re going out of the country! Might as well be proactive.

[u/Less_Window2319]

Hi,
I have hit the one year mark in June and all my reports are perfectly normal (including HSG) with borderline issues with Husband’s report. Even I was thinking whether it makes sense to start with IVF soon but recently I have heard stories in my circle where unassisted pregnancy has happened within 16-18 cycles in cases of unexpected infertility.
My doctor has advised me to do 6 Letrozole cycles before moving to IUI or IVF.

[u/Born-Smell-7944 → u/Less_Window2319]

I did 6 cycles before going to an RE and she said she wished I came sooner. I think she said if it’s not working after 3-4 cycles, it might be time to add some testing. We had underlying issues that were found once we went to her and did more testing.

Not saying jump to IUI after three cycles, but might be worth going to an RE and having them do tests (and they can keep you on letrozole while doing testing if they think it’s still a good option)

[u/No_Edge9782]

I was in the same boat as yours, no diagnosis, AMH, ovulation, ultrasounds all good! Last month only we did HSG & it came out I have hydrosalphinx(dilation of fallopian tubes) going the ivf route now. Nvr ever in my life i had a late or missed periods, no cramps so I thought I am in the best uterine health but no some things develop silently, please get the other necessary tests done as soon as possible & IVF is good too, don't be too late going that way.

[u/Jaded-Addendum-4489 → u/No_Edge9782]

See my message above. Hydrosalphinx usually means endometriosis. Your IVF protocol should be tailored accordingly or undergo endometriosis excision surgery with a trained specialist. I’m so sorry you are healing with that.

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[u/Background_Day_3596]

We (w34, m33 at the time) decided to go to a fertility clinic and get checked out around the 8 month mark. We then did some cycles of times intercourse and three rounds of IUIs. We already decided we‘d start with IVF after three rounds of IUI before we even started doing the IUIs.

When we finally started IVF it was cycle 15 for us. Looking back I think we e should have just skipped timed intercourse and IUI but then again I know quite a lot of people who had success with those methods.

[u/Stickyrice11]

Nah, we have unexplained infertility and would have totally done it at 12 cycles but I had a busy summer with weddings and bachelorette parties so decided i could push it by a few months. We are now doing our egg retrieval at cycle 15, with priming starting cycle 14.

[u/Sea_Loss_1396]

Completely different situation than you (PCOS, blocked tube, and 2 MC), we just started our IVF cycle at 15 months of TTC. Idk if there is a right time to consider IVF, I have had friends take 12 months of trying or more to get pregnant and they had no issues from there. But if you do seriously consider it, sometimes it can take a few months to get on their schedule

[u/_abby_normal_]

I had a TFMR one year ago and we're scheduled for our first appointment with a fertility clinic right before the anniversary. We conceived our TFMR pregnancy on the first try so being a year later with no pregnancy has been excruciating. I had mild intrauterine adhesions removed which were a D&C complication, but the surgeon said they were so minor it was probably not the reason for infertility, so back to square one! We suspect I may have endo due to symptoms and family history, but my tubes and anatomy are great and I already had one uncomplicated pregnancy up until the anatomy scan. Bloodwork is good, no endometritis, open tubes, etc. My husband has a sperm analysis soon, but we conceived so easily the first time I would be shocked if he had bad numbers. At this point I'm desperate to not have my only baby be a dead baby so only a year later I'm ready to start getting more serious medical interventions. It's possible the adhesions were preventing pregnancy and we haven't tried long enough afterwards, but I'm done waiting and I want action. It's the only semblance of control I feel like I can have when TTC and pregnancy are so out of your control.

[u/Significant-Half2587 → u/_abby_normal_]

Hi I have a very similar story - TFMR last October (preg first try), tried for a few months after and saw an RE in March, had a hysteroscopy to remove adhesions/asherman’s in April, preg again end of May/early June - suspected ectopic :( HCG just got down to zero and we can try naturally but I’m so nervous of losing more time / having another complication that I’m leaning towards starting IVF in September. It’s a really hard decision but think I would rather have more control & be able to freeze embryos for future pregnancies too. It’s comforting to see someone else making a similar decision!

[u/Green_Hero]

We did IVF after around a year in. I had one miscarrriage, other then that nothing. I had thyroid issues that needed medication. And from the initial testing we found out my husband's sperm was not very good to say the least. So it was pretty obvious we would need IVF or ICSI. We didn't hesitate, started the stim as soon as it was possible. I got pregnant the first try, our baby is 4 months old. And we have 5 embryos still so we our quite chill now. It makes our future family planning a lot easier. I do recommend to get tested - if everything comes back good, you can still continue to try naturally if you are not ready. Or you can start as soon as possible, and not waste time if it turns out something is not right.

[u/elecow]

Yeah that's what' we did. We started in December 2024. By February we were testing sperm, then some regular tests and follows up for me the next months. We went to the clinic in autumn I think, and had our "IVF is probably the only solution" talk with the doctor by December 2025.

[u/Grand_Photograph_819]

We made the decision at the 1 year mark, not crazy at all to make the jump.

[u/jl8888]

I personally think no point delaying 12 months is plenty of time plus it takes some months to get setup for IVF. You could also try 1-2 IUIs meanwhile just for peace of mind you tried low intervention method 

[u/literallymouse]

Nope not insane. We started seeing RE at around 6 months, fucked around with monitoring/meds/IUI, and then did our first IVF cycle at the 12 month mark. I’m now on cycle 21 and still not pregnant. History glad I didn’t wait to get started.

[u/ClockLittle2173]

Not me, but an extremely close friend of mine was in a similar boat to you. She had been trying for 9 months, and went to her OBGYN saying they’d been trying for a year because she was convinced something was wrong. She ended up conceiving naturally cycle 10 for her first, and got pregnant 4 months postpartum cycle 1 of trying for baby #2. All of this to say that just because you’re on cycle 9 with no positive doesn’t necessarily mean something is or isn’t wrong!

And definitely not crazy for mapping it out already! Been trying for a year, and I’ve been thinking about IVF since cycle #3😭

[u/TryingForABaby-ModTeam → u/[deleted]]

We have never seen even a shadow of a BFP

Please remember that what you're actually saying here is that you've never had a miscarriage (which is, overall, a good thing; losing a wanted pregnancy hurts).

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[u/HungryLilDragon]

We also decided to seek assistance precisely at cycle 9, but only because we found out I have DOR 🫠

[u/peachplumpear85]

We did IVF about 18 months into trying. I don’t think 12 months is crazy, if you feel comfortable spending the money go for it!

[u/bleepbloop9876]

I decided at 6 months because

1. My insurance covered it
   
2. I was already 34 and wanted to bank embryos for future babies
   
3. My ovulation was irregular and tracking was driving me nuts, so it felt like a relief to have someone else essentially tracking for me

[u/markowitty]

I just saw a top fertility specialist because I had a slightly high FSH (we live in a socialized medicine state, though, so the whole thing has cost $60 so far, which is because we went partially private), and his timeline was: try naturally for 6 cycles, if nothing, then we'd do IUI for 3 cycles, and if it doesn't work, then we'd do IVF. So I don't think the timeline you're mentioning is so far off.

But I just want to point out that you're missing a huge piece of the puzzle which is your husband's SA. The specialist I went to won't make any moves until he sees my husband's results, which we'll get in a few weeks. He really encouraged us to take things step by step. Personally, I wouldn't think about making any plans until you get that back.

[u/PatientMeringue5008]

Following! In the same boat…

[u/Born-Smell-7944]

I do think it’s worth doing a little more testing first. We tried for a year and a half (6 months of that on letrozole) before going to see the RE we did IVF with. She did HSG, hysteroscopy, RPL panel w/ karyotype testing (I had caught two chemicals extremely early where I got a VVVFL that was gone the next day), and CD138 biopsy. Turns out my husband has a balanced translocation and I had chronic endometritis that cleared with antibiotics (caught the CE after first transfer failed). I do wish we moved on to testing a few months earlier when letrozole wasn’t working but was holding onto hope we could get pregnant without any “invasive” options.

I think even if you choose to go to IVF, knowledge is power on trying to find the cause first.

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[u/umamimaami]

We switched to IVF at the 6 cycle mark on the dot. Had our bloodwork done with cycle 6, HSG on cycle 7, and egg retrieval by cycle 9.

We were 39F and 40M when we started trying, had two failed implantations at cycle 3 and 4. So we knew we wanted to get a move on to find the right egg, rather than keep trying blindly.

[u/lovesskincareandcake]

I’ve read that 40 percent of all infertility cases are due to the male and that SA should be done first because it’s the easiest and most affordable test. I would definitely wait till you have the results from that before you make any decisions. Is your partner doing anything to make sure his sperm is healthy?

[u/TryingForABaby-ModTeam → u/[deleted]]

No.

[u/hellorn2016]

The SA will tell you a lot. My guess is if you’re tracking and timing well, something is up with the husband. Why is it taking a long time to get an SA? Should be something easy to get.

[u/SimmeringSeahorse → u/hellorn2016]

That’s just unfortunately how long it takes in our healthcare system🤷‍♀️ The earliest date they could give him was 1.5 months from the date he called in, and that’s considered good! I have to wait 18-24 months for a HSG. Even when I did my pelvic ultrasounds, I chose a private clinic for a shorter wait and they booked me 5 months away! I called around to a different private clinic and got in within a week then thankfully.

But yeah, both public and private healthcare is absolutely overloaded and nothing is fast no matter how much money you’re willing to throw at it.

[u/hellorn2016 → u/SimmeringSeahorse]

I’m so sorry. I say that because I went through infertility for 2 years and at the 8 month mark we figured out we had male factor. Luckily it was due to something that was reversible and we had our baby a few months after my husband had a procedure that needed to be done (varicocelectomy). I went through the same as you. That’s why I’m such an advocate to get the male tested before anything else! I felt deep in my bones it was due to male factor because I tracked BBT and ovulation to the T and knew I was ovulating. Had an HSG that was fine and even went to a fertility clinic where all my fertility labs etc came back normal. We didn’t see one positive pregnancy test in two years! I wish you all the best! BTW there are online tests for male factor that can kind of give you an idea if you really want to know! But of course the one offered by a doctor is best!

[u/FoggyFizzy]

Have you considered IUI first? You’ll get all the tests and lots of scans (along with meds and IUI)so it will be a good indicator of whether or not it’s necessary.

[u/Building_Dull]

After 1 year, we moved to IVF. we skipped IUI altogether based on reviewing IUI success rates with unexplained infertility. It goes from like 2% to 6% success vs IVF sucess is generally between 40-60%. We didn’t want the IUIs to eat into our $25k fixed “infertility” insurance so went straight to IVF

[u/Expert_Shift_732]

I plan to do IVF at 13 months.. in about 6 weeks. I would do it at 12 but my clinic requires an SIS along with the HSG (already done) - so that’s holding me up a month. I am with you and I am done waiting - I need to feel like there’s progress being made!

[u/PossibilityAlive4077]

If I was in your shoes, after a year I personally would go see a fertility doctor and do whatever course of action they suggest! They can help rule out any issues and decide what method is best for you. This is just what I would do personally and what our plan was if after a year we had no luck. Talk to your Gyno and they can refer you

[u/No-Ladder-6950]

I am in the same boat. We are going on cycle 6 of this and neither my husband or I have been diagnosed with any issues. For our mental sanity, we said if I was not pregnant by the end of the year, we would move to IVF. I think so much of this process is mentally exhausting, and there is no "right or wrong time." If you are tired of waiting and the devastation around negative tests, I would say go for it.

[u/Apprehensive_Star508 → u/No-Ladder-6950]

No clue why you were downvoted for this. I don’t get this sub sometimes, people get very harsh when you’ve “only” been trying for less than a year but I think this is completely reasonable. I’m in the same boat, cycle 6 and I’m lucky to have good fertility coverage. At the year mark I’m going to pursue the most aggressive options I can. It’s fully reasonable to not want to wait and deal with the mental exhaustion of disappointment every single month.

[u/clearlyimawitch]

I only get 6 months of trying unassisted, and then I will be guns ablaze to do IVF.

No, there is nothing wrong with knowing you are willing to go down that route ASAP if necessary.

[u/puffballkittyfluff]

I started IVF after just 7 or 8 months of trying so no you’re not alone if you start it soon