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I went in to see my OBGYN in the middle of my 6th cycle trying because I was having excrutiating pain during AF. They did 2 ultrasounds to make sure everything looked ok, then pretty much sent me on my way (with a script for Naproxen...) and told me to come back @ 12 months TTC. We did an SA this cycle (#11) and will probably wait until February (cycle #14) to do an HSG.

I think if you have had stellar timing for 6 months straight (be able to back that up with + opk's or charting, etc) it may be a good idea to talk to your OB.

ETA - I'm 25 and am in no rush to get KU 1-2-3 so I haven't been super pushy with my OB. If I wanted things to move a little more quickly I could probably make it happen.

@littlek: I'm in my 6th cycle but 7th month of TTC for #2. M took 9 cycles but almost a year. With M my OB was willing to refer me to a specialist after 6 months.
Those all contribute to me deciding it's time to get some medical assistance.

And I really don't want our kids to be more than 3yrs apart. I'm 31 and DH is 35.

I was already seeing my GYN for issues so TTC was always a topic between us.
I have had issues with my cycles ever since my period started, ranging from my period stopping to getting it every two weeks. I was getting blood tests and ultrasounds to try to figure out why. When we started TTC I was getting my period every two weeks, which usually isn't long enough for implantation to occur. Since as I was already working with my GYN to figure out the cycle length issues they gave me an HSG without having to wait too many cycles.

I talked to my gyne after I realized my cycles were really, really long. He did some preliminary blood work so we knew I was anovulatory, but I wasn't referred to an RE until a year later (insurance policy).

I decided to talk to my OB after about 6 months of TTC and having had really unpredictable cycles. After blood work confirmed that I was definitely ovulating, she suggested clomid to help regulate my cycle and boost ovulation a bit but then I had to go in for a LEEP then a random BFP that ended in a MC so i never got to try clomid. My cycles post-miscarriage have been (so far, keeping my fingers crossed) quite regular so I'm holding off on clomid at the moment.

@locavore_mama: happy to!

We aren't there yet but I talked to my doctor at the time she removed my iud and she told me to give it 6 months and then come in for preliminary testing. I have had previous issues though so I was nervous going into the process as a result.

A great book to have on hand is Taking Control Of Your Fertility. It helps to get to your your body and your natural cues of ovulation, etc.

I went to my Gyn about 3 months into TTC because I was having sharp stabbing pains on my lower right side around the middle of my cycle and super light periods (which was NOT the case before I went on BCP). I had super regular, ovulatory cycles right off BCP, so I thought something might be up. She referred me to a pelvic pain specialist (also a Gyn), who ordered a bunch of tests (u/s, SA, bloodwork) and asked a lot of questions about my pre-BCP periods and family history. She didn't find anything, but the pain kept getting worse and more frequent.

She suspected endometriosis and asked me to have surgery to check it out (this was around cycle 6). I declined because I was just *so* sure that I would get KU soon. Finally, the pain got so bad that my husband practically carried me into the OR. I had surgery cycle 11. Diagnosis: endometriosis and two blocked tubes. I never stood a chance. My Gyn was able to unblock one of my tubes (on the right, duh - that pain had been my endo growing), but the other is filled with old growth and is beyond hope.

Cycle 12 I O'ed on the left. Cycle 13 I got KU.

Turns out that every single woman in my family has endometriosis. My grandmother had a hysterectomy at 36. All 5 of her sisters also had it. My mom has undiagnosed, but very apparent, endo. She never had any fertility issues because she went on BCP super early and had kids young. My daughter is going on BCP as soon as she gets AF. Sad, but I don't want her to go through what I have if she wants to have kids.

My doctor wants us to have our kids close together so I don't lose whatever fertility I have left (the endo pain returned 7 weeks postpartum and I had been on crazy hormones since then until about 2 weeks ago in an effort to staunch the growth).

Sigh.

LONG story short: My Gyn was really proactive and very helpful to me. FWIW, she thinks the 12 month rule is BS. She says that you should get KU within 6 months of truly TTC (charting, timing, etc.). If it's been 6 months and nothing's going, she thinks you should get tested and seek intervention.