You and your partner still have plenty of options even if you’ve not managed to conceive after trying for more than 12 months.
When should I seek medical help?
Most couples who are trying for a baby and having regular sex without any contraception don’t need to seek medical advice until they have been trying for two years, according to the HFEA.
For 95% of couples where there’s no medical problem, previously detected or otherwise, successful conception will happen within 12 months.
If you’re under 35, it’s suggested you don’t need to seek help until you’ve been trying for 18-24 months.
If you’re over 35, it’s advised that you try naturally for about six months, then seek some tests. This is because if tests suggest you do need assisted conception of any kind, it can mean a long wait, and that extra time can affect the quality of your eggs after 35 years of age.
What if I’m not pregnant after 12 months of trying to conceive?
Unless there’s a reason why your own gynaelogical history might affect your chances of getting pregnant, the first tests your doctor is likely to carry out are simple blood tests and possibly a cervical smear test if you’ve not had one recently.
A blood test taken seven days before your usual menstrual due date will show if your ovulation is normal. A second test during your period will help to show if your hormone balance is ok.
You may also be checked to see if you’ve been immunised against German measles (rubella) so that you’re safe once you get pregnant. You may be tested for chlamydia, which is a very common sexually transmitted disease that can go unnoticed for years, but can seriously affect your ability to conceive.
What tests will my partner have?
The first tests a man will have check that his sperm is normal (this is done by giving a sample). He’ll probably have a urine test for chlamydia, too.
Eggs fine, sperm fine – what do we do next?
- After problems with the health of egg and sperm production, the HFEA expect the following causes for trouble conceiving are most likely:
- 16.7% of failures will be due to a problem with your fallopian tubes, which carry the fertilised egg to your womb for implantation
- 4.9% will be caused by ovulatory problems
- 3% will be caused by endometriosis
- 0.3% will be affected by issues in the uterus that are hindering successful implantation of the egg
- 17% will be a combination of the above
- 18.7% will be because of ‘no particular reason’
At this point, your doctor may prefer to discuss lifestyle changes and suggest you continue trying to conceive through regular unprotected sex. Stress, diet and habits like smoking and drinking can affect your ability to conceive.
What other tests might I have?
If you’re not pregnant after 12 months, don’t worry. IVF and other treatments are still a long way off at this point and there are other fertility tests that you can have.
Previous operations, infections or the growth of painless polyps and fibroids can all affect your reproductive organs and many can be dealt with quite simply.
The following checks can be made:
- An ultrasound check at hospital can look in more detail at your ovaries and womb
- A specialist may want to take a sample of the tissue lining your womb
- A different series of ultrasound scans can track the development of your eggs
- An X-ray can check that your fallopian tubes are clear of any blockages
- A laparoscopy (sending a tiny camera on a tube through your cervix) can check for other tube blockages
- A vaginal ultrasound may do a similar check for blockages
- A hysteroscopy will look for fibroids and polyps
You probably won’t need to have lots of these tests, just specific ones depending on discussions with your doctor and any specialist you’ve been referred to.