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In accordance with American Society for Reproductive Medicine (ASRM) guidelines, referral to a reproductive endocrinologist may be appropriate after 12 months of attempting conception for women under 35 years, after 6 months for women 35-39 years, and earlier for women 40 years and older or those with known risk factors such as irregular menstrual cycles, PCOS, tubal disease, endometriosis, or male factor infertility

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