When to get medical help
See your GP if you haven't conceived after a year of trying.
You should see your GP sooner if you:
- are a woman aged 36 or over – the decline in fertility speeds up when a woman reaches her mid-30s
- have any reason to be concerned about your fertility – for example, if you've had treatment for cancer or you think you might have had a sexually transmitted infection (STI)
Fertility tests can take time and female fertility decreases with age, so it's best to make an appointment early on.
Your GP will be able to carry out an initial assessment to check things that may be causing your fertility problems and advise you about what to do next.
It's always best for both partners to visit their GP as fertility problems can affect a man or a woman, or sometimes both.
Trying to conceive can be an emotional process, so it's important to support each other as much as possible. Stress is just one factor that can affect fertility.
Questions your doctor may ask
Your GP will ask you about your medical and sexual history.
Previous pregnancies and children
If you're a woman, your GP will want to discuss any previous births and any complications with previous pregnancies.
They'll also ask about any miscarriages you've had.
If you're a man, you'll be asked whether you've had any children from previous relationships.
Length of time trying to conceive
Your GP will ask how long you've been trying to conceive.
More than 80% of couples will conceive within a year if:
- the woman is under 40 years of age, and
- they don't use contraception and have regular sex (every 2 to 3 days)
Of those who don't conceive in the first year, about half will do so in the second year.
If you're young and healthy and haven't been trying for a baby for very long, you may be advised to keep trying for a little longer.
You'll be asked how often you have sex and whether you have any difficulties during sex.
You may feel uncomfortable or embarrassed discussing your sex life with your GP, but it's best to be open and honest.
If the fertility problem is to do with sex, it might be overcome easily.
Length of time since stopping contraception
You'll be asked about the type of contraception you previously used and when you stopped using it.
It can sometimes take a while for certain types of contraception to stop working and this may be affecting your fertility.
Medical history and symptoms
Your GP will want to discuss any medical conditions you have or have had in the past, including sexually transmitted infections (STIs).
If you're a woman, your GP may ask how regular your periods are and whether you experience any bleeding between periods or after sex.
Some medications can affect your fertility. Your GP will ask you about any medication you're taking, and might discuss alternative treatments with you.
You should mention any non-prescription medication you're taking, including herbal medicines.
Several lifestyle factors can affect your fertility. Your GP will want to know:
- if you smoke
- how much you weigh
- how much alcohol you drink
- whether you take any illegal drugs
- if you're stressed
They may recommend making changes to your lifestyle to increase your chances of conceiving.
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After asking you questions, your GP may carry out a physical examination or refer you for tests.
If you're a woman, your GP may:
- weigh you to see if you have a healthy body mass index (BMI)
- examine your pelvic area to check for infection, lumps or tenderness, which could be a sign of fibroids, ovarian tumours, endometriosis or pelvic inflammatory disease (PID) – see causes of infertility
If you're a man, your GP may check your:
- testicles to look for any lumps or deformities
- penis to look at its shape, structure and any obvious abnormalities
After a physical examination, you may be referred to a specialist infertility team at an NHS hospital or fertility clinic for further tests.
Fertility tests for women
Tests to find out the cause of infertility in women include:
A sample of your blood can be tested for a hormone called progesterone to check whether you're ovulating.
The timing of the test is based on how regular your periods are.
If you have irregular periods, you'll be offered a test to measure hormones called gonadotrophins, which stimulate the ovaries to produce eggs.
Chlamydia is an STI that can affect fertility. A swab – similar to a cotton bud, but smaller, soft and rounded – is used to collect some cells from your cervix to test for chlamydia.
Alternatively, a urine test may be used.
You'll be prescribed antibiotics if you have chlamydia.
An ultrasound scan can be used to check your ovaries, womb and fallopian tubes. Certain conditions that can affect the womb, such as endometriosis and fibroids, can prevent pregnancy.
A scan can also be used to look for signs that your fallopian tubes – the tubes that connect the ovaries and the womb – may be blocked, which may be stopping eggs travelling along the tubes and into the womb.
If the ultrasound suggests a possible blockage, your doctor will refer you to a specialist to discuss further checks, such as a laparoscopy.
During a transvaginal ultrasound scan, a small ultrasound probe is placed in your vagina. The scan can be used to check the health of your womb and ovaries and for any blockages in your fallopian tubes.
A hysterosalpingo-contrast-ultrasonography is a special type of ultrasound scan sometimes used to check the fallopian tubes.
A small amount of fluid is injected into your womb through a tube put into the neck of your womb (the cervix).
Ultrasound is used to look at the fluid as it passes through the fallopian tubes to check for any blockages or abnormalities.
Again, if the test suggests a possible blockage, your doctor will refer you to a specialist to discuss further checks, such as laparoscopy.
A hysterosalpingogram is an X-ray of your womb and fallopian tubes after a special dye has been injected.
It can be used to detect blockages in your fallopian tubes, which may be stopping eggs travelling along the tubes and into your womb.
Laparoscopy (keyhole surgery) involves making a small cut in your lower tummy so a thin tube with a camera at the end (a laparoscope) can be inserted to examine your womb, fallopian tubes and ovaries.
Dye may be injected into your fallopian tubes through your cervix to highlight any blockages in them.
Laparoscopy is usually only used if it's likely that you have a problem – for example, if you've had an episode of pelvic inflammatory disease (PID) in the past, or if your scan suggests a possible blockage of one or both of your tubes.
Fertility tests for men
Tests to find out the cause of infertility in men include:
This is to check for sperm problems, such as a low sperm count or sperm that aren't moving properly.
A sample of your urine will be tested to check for chlamydia, as it can affect fertility.
Your GP will prescribe antibiotics if you have chlamydia.
Read about the different treatments for infertility.