Six cycles. Six negative tests. And by now at least one person has told you to “just relax and it will happen”. That advice is not a plan. This page is the version we would give a friend at the six-month mark: what the guidelines actually say, what is worth checking, and where supplements do and do not fit.
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Six months is a real checkpoint — here is what the guidelines say
Fertility specialists in the US and Canada work to a rough rule: a workup is generally suggested after 12 months of regular unprotected sex if the woman is under 35, and after 6 months if she is 35 or older. Earlier than that if there is a known reason — irregular or absent cycles, known fibroids or endometriosis, previous pelvic surgery or infection, or a known male-factor history.
So if you are 35 or over, six months is not “too early to ask” — it is exactly the point at which asking is standard. If you are under 35 with regular cycles, six months is genuinely still within the normal range, but it is a sensible moment to tighten up the basics and get the easy tests started so you are not beginning from zero at month twelve. Referral waits in both countries are long enough that starting the paperwork early costs you nothing.
Three things worth checking before another six months pass
These are the checks that most often change the plan, in rough order of how quick and cheap they are:
- A semen analysis. It is the fastest, cheapest and least invasive test in fertility, and male factor is involved in around half of cases — yet it is routinely done last. Do it first. Background: male fertility and sperm health.
- Confirmation that you are ovulating. Not “my app says day 14” — an actual pattern from tracking plus, if needed, a mid-luteal progesterone blood test. Start with cycle tracking; if cycles are long, irregular or absent, read PCOS, anovulation and thyroid and conception.
- The plumbing and the reserve. An HSG to look at the fallopian tubes and uterine cavity, plus AMH and antral follicle count if you are over 35 or have had ovarian surgery. Tubal factor is common and completely invisible from the outside — and no supplement addresses it, as we explain in can supplements unblock fallopian tubes.
If everything comes back normal and you are still waiting, that has its own name and its own guide: unexplained infertility. If you already have one child, see secondary infertility.
See the full AGO range and combo pricing →
The AGO combo most couples start with at the six-month mark
The starting point is deliberately simple — one product each, both partners, same day:
- AGO Mom (her) — the base of the plan, designed to support everyday egg-cell, ovulation and reproductive wellness.
- AGO Dad (him) — the his-side base for everyday male reproductive wellness. Together these two are the Mom + Dad his-and-hers starter combo.
- Irregular or painful cycles? Many add AGO Eva, or Eva Herblux if PCOS is in the picture.
- Known fibroids? AGO Tumor is the usual addition for everyday uterine wellness — alongside your doctor’s plan, never instead of it.
- Known or suspected tubal issues? See the blocked fallopian tubes guide — and read it for the honest limits as much as the combo.
Not sure which of those applies to you? The which-combo buyer guide walks through it, and the TTC starter guide covers the basics. What these products are designed to do is support everyday wellness — they do not diagnose anything, and they are not a substitute for the three checks above.
Why 90 days is the unit of time that matters
Both eggs and sperm mature over roughly three months before the cycle they appear in. That is why fertility teams ask about the last 90 days of sleep, alcohol, smoking and stress at the first appointment, and why a supplement routine is measured in months rather than weeks — more in how long to take AGO supplements.
Practically: if you start today, month nine of trying is the first month that reflects it. That is also roughly when a referral appointment tends to land, which is convenient rather than coincidental. The unglamorous inputs count here too — sleep, stress, and the rest of the preconception checklist. Before you stack anything, read how to combine sensibly and who should ask a doctor first.
What to do while you wait for a referral — and when to stop waiting
- Book the semen analysis now. In most of the US and Canada it does not need a fertility referral, and it is the single most informative early test.
- Ask your family doctor or OB-GYN for the bloodwork while you wait for the specialist: day-3 hormones, TSH, prolactin, and AMH if indicated. Arriving with results shortens the first appointment considerably.
- Check your coverage before the first bill. Ask what your plan covers for diagnostics versus treatment, and in Canada ask what the provincial programme funds and what its waitlist looks like.
- Stop waiting if any of these apply: you are 35 or over, cycles are irregular or absent, there is known tubal, uterine or male-factor history, or you have had two or more pregnancy losses. Ask for the referral now rather than at month twelve.
- Protect the relationship. Timed intercourse for six months is its own kind of tiring. Agree on how much tracking you both actually want.
If you want a second pair of eyes on where you are, tell our care team your cycle history and how long you have been trying and we will map a plan with you — free, with no pressure to order. Pricing and shipping: the combo pricing guide and where to buy in the US and Canada. If you are already over 35, start with the after-35 combo guide.