I am 25 and have been having sex without contraception for six years (my partner and I are monogamous). I am not in a hurry to have a child right away, but I would like to know why I have not gotten pregnant. My doctor says there is no need to be concerned because I am not anxious about having a child at the moment. The doctor also told me that everything "looks normal." Could I be missing something that will affect my chances of having a child in the future if I do not pursue further investigation of my infertility now?

Carolyn

There certainly may be something going on that could affect your ability to become pregnant, but in general we do not begin an infertility investigation until one has actually been trying to get pregnant. If you are having menstrual irregularities, you may not be ovulating, and this should be investigated regardless of current or future desires for children. If you have unusually painful periods or pain with intercourse, this again should be evaluated whether or not you wish to become pregnant.

However, if you are having no other problems, then investigation of fertility status should wait until you have actually tried to conceive for several months. The infertility workup is expensive and involved; surgery may even be required. And your partner may be the one with a problem anyway -- male factors account for about 40 percent of all cases of infertility!

In any event, if you do not wish to become pregnant at this time, you should be using some type of contraception. Many a mother thought she couldn't get pregnant just because she had been lucky up until that point!