Trying to conceive

Trouble conceiving.

Most of the first workup belongs in a general OB-GYN office. This page says exactly what we do here, what we refer to reproductive endocrinology, and when that referral should happen rather than later.

What we do here

The first-line workup, in one office

  1. 01

    Cycle history and ovulation confirmation

    Mid-luteal progesterone or tracking, rather than assuming anovulation from an irregular cycle.

  2. 02

    Ovarian reserve

    AMH, antral follicle count on ultrasound, and day-3 FSH where it adds anything.

  3. 03

    Thyroid function and prolactin

    Because both are common, both cause this, and both are treatable in a general office.

  4. 04

    Tubal assessment

    Hysterosalpingography, or saline infusion sonography where it is the better test.

  5. 05

    A semen analysis for your partner

    Ordered at the same visit. Male factor is involved in roughly half of cases and is the fastest thing on this list to test.

  6. 06

    Preconception care alongside it folate, rubella and varicella immunity, carrier screening, a medication review and blood pressure.

When to go straight to a specialist

Reasons not to spend a year here first

You are 35 or over and have been trying six months

Under 35, the threshold is twelve.

Cycles are absent or longer than 35 days

That is a specific problem with a specific workup, and waiting adds nothing.

Known endometriosis

Previous pelvic surgery, or a blocked tube on imaging.

Two or more miscarriages

Recurrent pregnancy loss has its own workup and should not wait for a third.

An abnormal semen analysis

Which is a urology or reproductive endocrinology referral rather than something to repeat twice here.

Trying to conceive: common questions

Do you do IVF?
No. IVF, IUI and ovulation induction with injectable gonadotropins are reproductive endocrinology, and we refer for them. We do the workup that tells you whether you need them, which is most of what the first six months consists of.
Will insurance cover any of this?
The diagnostic workup is usually covered as a medical benefit; treatment often is not, and Florida does not mandate infertility coverage. Which of your plan’s products covers what is on the payer page for your plan, and we verify it before ordering.
Will you prescribe letrozole or clomiphene?
For straightforward anovulation with open tubes and a normal semen analysis, yes, with monitoring. Where the picture is more complicated than that, starting it here would only delay the referral.
How long should we try before asking?
Twelve months under 35, six months at 35 and over, and straight away if cycles are irregular or absent. Coming in earlier to ask is never wrong — preconception care is worth a visit on its own.

Know before you book.

Vireo opens in 2027. Until then the plan list, panel status and first-available wait for every office are published on this site and kept current. Questions can go to the practice office on (305) 555-0180.

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