Stages of Infertility

Infertility does not have fixed medical stages. This guide describes the usual path from trying to conceive to specialist care.

1. Trying naturally

Having regular unprotected sex every 2 to 3 days across the cycle is the usual advice. Most couples conceive within a year. A healthy lifestyle and folic acid for the woman help from the start.

2. Initial evaluation (after 12 months, or 6 months if 35 or older)

Both partners see a doctor. Typical checks:

• History and examination
• Semen analysis for the man
• Tests for ovulation and hormones for the woman
• Pelvic ultrasound

3. Further investigation

• Tests of fallopian tubes and uterus, such as hysterosalpingography or ultrasound
• Ovarian reserve tests such as AMH and antral follicle count
• Further male tests if semen results are abnormal

4. Treatment choices

• Treat the cause, such as thyroid disease or a varicocele
• Ovulation induction with medicines
• Intrauterine insemination (IUI)
• In vitro fertilisation (IVF) or ICSI
• Surgery for conditions such as fibroids, polyps or endometriosis

5. Review and next steps

Treatment is reviewed regularly. Some couples choose other options such as donor gametes or adoption. Emotional support is important at every stage.

Key point

Age is the main factor in timing. Do not wait too long to ask for help.

Before your appointment

Come as a couple if you can. Note how long you have been trying, cycle length and regularity, past pregnancies, surgeries, infections and medicines. Bring past reports and, if available, a semen analysis. List supplements and herbs you take, along with smoking, alcohol and exercise habits. Ask about tests, treatment options, costs, success rates and the warning signs that mean you should call 112 or 102.