r/TryingForABaby • u/Previous_Cookie6937 • 6d ago
QUESTION When am I considered infertile?
Hi- I turn 35 November 3. I went off birth control December 23, 2026 and have had one miscarriage and no other pregnancies. I know for 34 year olds, you have to try to conceive naturally for 12 months but for 35 year olds, it’s only 6 months. Since I’m turning 35 before my “12 months of trying as a 34 year old,” would I immediately qualify for an infertility diagnosis (& thus insurance would pay for REI/IVF stuff) when I turn 35? Because when I turn 35 in November I will have “11 months of trying and now I’m 35”
Sorry so confusing. I’ve tried to look online and can’t find clear answers, insurance is really unhelpful, and this whole process has been emotionally awful as everyone around me seems to get pregnant the second they consider trying
Edit: I’m in Massachusetts and have BCBS PPO but they will only tell me the 12 months as a 34 year old / 6 months as a 35 year old. No one will tell me what happens as someone who’s turning 35 before the 12 month mark
Second edit: please stop telling me to ignore the timelines. I believe in the evidence-based guidelines and our medical experts, I’m more trying to understand what happens when I change from under 35 to 35 and up
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u/b182rulez 5d ago
Once you turn 35 you qualify for the 6 months threshold so I would make an appointment for right after your birthday
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u/karaboocuk 5d ago
I believe the testing is considered before an infertility diagnosis, since they are part of that diagnosis. A lot of the tests can be done by your OB as well. if you started the tests now, they will usually take a cycle/month or longer just because they need to be done at certain days of your cycle. By the time you have a "diagnosis", the timelines would work out either way I am sure.
Don't want to scare you, but there was a post here a month or so ago about a woman getting diagnosed as infertile right away, before tests, because she tried for 12 months and her OB entered the diagnosis. But then the insurance denied all the test coverage because she already had a diagnosis. Hate these companies!
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u/LickMyRawBerry 5d ago
My doctor did this, too. I’m having a hell of a time fighting it.
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u/Previous_Cookie6937 4d ago
This is what I think will happen to me, but I’m trying to figure out if it’s 6 or 12 months for me…..
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u/foolforgabagool 5d ago
Depends on your insurance. I could not get infertility testing (all labs, HSG) until a consult with infertility, and could not get a consult with infertility until a referral, which was only given after the established 6/12 months trying minimum.
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u/mantisroseb 5d ago
The reason the recommendation to reach out drops to 6 months is solely due to age, because fertility treatments are less likely to work as we get older, so Drs don't want you to delay care. If you go into your OBGYN sooner, say around your birthday, I'm sure they will be able to run your benefits and tell you what's covered... and I feel like you'll be fine with it only being 6 months.
I'm 39 and am only in cycle 4, but I already have an appointment booked for a fertility chat with my OBGYN for November. Your OB is here to help you and they're happy to see you sooner rather than later. From my understanding, extensive testing is required before doing interventions, which could take some time anyway. Imo no reason to delay asking for help
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u/peachypie1010 5d ago
I was told to try for 4-6 months since we had suspected endometriosis (now confirmed) and then come in to be recommended to a clinic. I was only 25. I still tried for a year cause I didn’t want to believe it. Then I just called and booked myself in. Follow your own timeline!
I’m not sure if you’re hoping for an official referral for insurance sake but most insurances will not cover fertility treatments. You should call your specific carrier and ask however. We did still run every bill through our insurance because they would negotiate it for us and it would usually take 100 or so off.
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u/Previous_Cookie6937 5d ago
Aw sorry to hear that
And my insurance covers infertility treatments, I was just trying to figure out when I’m eligible
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u/Repulsive-Baby-8288 5d ago
I’m in MA and also have BCBS of MA for insurance! You don’t need a referral to book an appt with a fertility clinic so start calling now to book one. They will ask about timeline and you just explain you’ve been trying for almost 11 months but also turn 35 next month. Fertility clinics typically have a long wait (I booked mine and it took six weeks until my intake appt), so you will prob be over 35 by the time you get in.
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u/Becsbeech 5d ago
I know this isnt everyone's path, and you may choose to do elsewise...
At 32 I went to my OBGYN after 10 months of trying (technically during my 10th cycle) and got preliminary tests out of the way. By the time i failed my hsg and needed a specialist, I had hit that 12 month window. Granted, they found the reason for my infertility so I would have qualified for care regardless, but what im saying is the process takes a long time. Getting the preliminary testing done by an obgyn may be the loophole you need for insurance. Idk.
I was fortunate that there wasn't a long wait for my RE's office as well. I'm now on month 16 of ttc and hopefully my FET is next month.
I wish you luck
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u/developmentalbiology 6d ago
You will have been trying longer than six months at the time you turn 35, so you can initiate investigation at that point.
Kind of a technicality, but folks are just encouraged to start investigation earlier at 35+ -- it's not that you would actually be diagnosed with infertility after six months trying at 35+. But people tend to conflate the time of diagnosis with the time it's suggested to start medical testing.
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u/DrZuzulu 6d ago
Sounds like an insurance question, and that depends on your insurance and where you live.
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u/Previous_Cookie6937 6d ago
I tried calling but the BCBS rep just kept repeating I need 6 months of trying as a 35 year old. I asked if that included my 11 months as a 34 year old and she was like no you need 12 months as a 35 year old. It was an incredibly frustrating and circular conversation so I decided to try Reddit
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u/ohfuckwhatmaybe 6d ago
The BCBS rep is wrong - call back and ask “if I’m 35 and have been trying for more than 6 months, am I considered infertile?” The answer is yes - it makes no sense that it would take longer to consider you infertile if you are 34 turning 35 than if you were 33 turning 34.
I’ll quote the BCBS of MA wording: “An otherwise healthy biological female is age 35 or older and has not been able to conceive after a period of six months of actively trying”. You just need both of these things to be true.
Call back and ask the question again.
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u/Leigho7 6d ago
It’s only a month difference. There’s nothing stopping you from pursuing some testing now and a lot of it could be billed as just general pre-conception stuff. IVF takes time to even get going so I’d personally just start pursuing this stuff now. Who knows how long it will take to get the right appointments anyway.
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u/SaladDramatic5161 5d ago
I’m sorry for your loss. Did you have a sonohystogram or hsg after you had the miscarriage?
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u/DawgCheck2495 5d ago
I’m 33. I told my OBGYN at my annual at 2025 that we were going to start trying. When I wasn’t pregnant at my annual in 2026, she considered it a year and ordered hormone panels for me and a semen analysis for my husband. Turns out I have low AMH (they considered it borderline at 0.92), but I’m grateful we didn’t wait any longer to investigate.
(Technically, we’d only been actively trying for 7-8 months at the time.)
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u/Classic-Paramedic270 5d ago
It depends on age, typically 1 year but its after 6 months fir age 35 and up.
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u/General_Radio7713 5d ago
Start the conversation with your OB now. Referrals take time anyways. And with the history of a miscarriage, get your progesterone checked.
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u/Gingerella083 5d ago
I'm in Canada so it might be different, but once my partner and I hit 6 months of ttc with no luck, I self referred to fertility specialists because I have PCOS, and here its 35 or known fertility issues. I will also be 35 in November but have been working with a fertility specialist since February, fully covered by my provincial health insurance.
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u/Himalayanmthummer 5d ago
I would make an appointment sooner than later. By the time you even start IVF, it’ll be over the 12 month mark anyways. It usually takes a month or two to get into an RE and then you’ll have a work up (based on what comes up from labs). I wouldn’t get too worked up about the 12 months vs 6 months situation
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u/Waffly_good 4d ago
If I was you, wanting to start fertility treatments, I would switch providers and exaggerate how long I’ve been trying.
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u/Azariah77777 3d ago
The short answer is that you need to talk to your insurance company. All that matters is how THEY define it.
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u/Previous_Cookie6937 5d ago
I’m not anxious, I’m trying to figure out my insurance coverage ?
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u/AppraiseMe 5d ago
I thought you were asking if you were infertile.
We can’t tell you that. A clinic will be able to tell you.
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u/Previous_Cookie6937 5d ago
Obviously you can’t tell me that… I was asking about the insurance. No need to reply to this, I think a different post may be better for your time and attention. Thanks!
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u/TryingForABaby-ModTeam 5d ago
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u/jaanlo1616 5d ago
OP may need to be extremely literal to interpret her coverage correctly. It feels like insurance is purposefully incomprehensible sometimes.
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u/Previous_Cookie6937 5d ago
Well insurance paid for my IUD removal so that’s a pretty clear paper trail
I think it’s a risk-benefit situation (no need for all the workup if you end up getting pregnant naturally) so I’d rather follow the OB gyn guidelines. I just want to know how they apply to me1
u/squeaky127 5d ago
If you’re one month away, by the time you book the appointment / come up to the appointment, you will be at around the 1 year mark anyway. New guidance in research suggests getting help sooner and that one year is long to wait now. But that’s just what I have been seeing and reading. I work in the medical field so I always follow research trends.
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u/Majestic_Ferret_826 2d ago
My reproductive endo taught me that diagnosis is actually a good thing bc insurance won’t cover anything without that official diagnosis. It has less to do about you being infertile and more about increasing testing and being recognized by health insurance
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u/gellahaggs 5d ago
If you want to get technical, when you turn 35 you’ve actually just completed your 35th year… so I would schedule a consult with one of the fertility clinics nearby (do your research on them as I’ve heard horror stories on some in the area) and let them know. I don’t see them denying you bc you’ve just turned 35 but haven’t actively been trying for 12 cycles.
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u/Kvitravn875 5d ago edited 5d ago
My guess is that they would make you wait the extra month because you would be newly 35, and not trying for 6 months during the age of 35. Most of your ttc has been while you are 34. I know it feels like time is of the essence, but it's only a month and it will be gone before you know it. Much luck to you!
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u/TryingForABaby-ModTeam 5d ago
Your post/comment has been removed for violating sub rules. Per our posted rules:
Posts/comments about positive tests and current pregnancies should be posted in the weekly BFP thread. In threads/comments other than the weekly BFP thread, pregnant users must avoid referring to a positive test result or current (ongoing) pregnancy.
This rule includes any potentially positive result, even if it's faint or ambiguous. All concerns related to current pregnancies should use a pregnancy sub, such as r/CautiousBB.
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