Getting started with fertility care

Where to begin

Starting to think about fertility care can feel overwhelming. In most cases, the first steps are a conversation about your history and some initial tests — not an immediate leap to treatment.

When to seek help

UK guidance from the NHS suggests seeing a GP if you have not conceived after about a year of regular, unprotected sex — and sooner if the woman or person with ovaries is 36 or over, or if either partner already knows they may have a fertility problem. The WHO defines infertility as not conceiving after 12 or more months of trying. (In the US, ASRM suggests evaluation after a year, or after six months from age 35 — so exact thresholds vary by country.) Because timing is individual, use this as a prompt to ask a clinician what makes sense for you rather than waiting.

What an initial assessment involves

A GP can check for common causes and refer you on if needed. Standard investigations usually include a semen analysis, assessment of ovulation, and checks of the fallopian tubes and uterus. Common causes that may be identified include ovulation problems, poor semen quality, blocked or damaged tubes, and endometriosis — and in about a quarter of couples, no cause is found (unexplained infertility). Modern NICE guidance is explicitly inclusive and applies regardless of sexual orientation, relationship status, or gender identity.

Prepare for your appointment

Bringing a short list of questions helps you get the most from limited appointment time. Factors worth raising include age, weight, smoking, and alcohol. Our questions to ask guide can help you build a list, and choosing a clinic explains what to compare.