Trying to conceive: when to get help

The usual advice to ask for help after 1 year of trying has exceptions. Age, irregular periods, known fertility concerns and difficulty having sex can all be reasons for an earlier conversation. You can ask about these before reaching a time limit.

What counts as regular trying

For people trying through vaginal sex, the NHS suggests sex without contraception every 2 to 3 days. This approach does not require identifying an exact ovulation day. Talk about what feels manageable for you, including any difficulty keeping to that timing.

The timings below apply to trying through sex. Other routes to parenthood may need a different approach. WHO recognises that people who are single, in same-sex relationships or need fertility care for medical reasons may need services too. If you need donor sperm or another supported route, ask a clinician about planning care from the start.

UK and US timings are different

Where the advice comes from	When to discuss assessment
NHS general advice	After 1 year of trying through sex; sooner if you are 36 or over or have a reason for concern.
CDC: woman under 35 years old, with regular periods and no known concerns	After one year of trying.
CDC: woman 35 years or older, with regular periods and no known concerns	After 6 months of trying.
CDC: woman older than 40	Consider more immediate assessment.

NHS pages also word the advice differently: its general infertility page says to seek help sooner at 36 or over, while its low-sperm-count page specifies 6 months if the partner trying to conceive is 36 or over. Ask your GP about referral timing; the general advice does not require you to wait those months before raising a concern.

WHO uses 12 months or more of regular unprotected sexual intercourse in its definition of infertility. You can still seek an earlier assessment when it is recommended because of your age or medical history.

Reasons to ask sooner

Book a GP appointment in the UK, or see your doctor in the US or elsewhere, if periods are absent or irregular, or there is a history of endometriosis, very painful periods or pelvic inflammatory disease. CDC advice identifies these as reasons not to delay assessment while trying.

Mention a history of testicular injury, chemotherapy or fertility difficulties with another partner too. The NHS also advises discussing known low sperm count and difficulty having sex. An earlier conversation gives you a chance to discuss these concerns.

What the first checks may involve

An assessment starts with your medical and sexual history. If you are trying with a partner, both histories matter. The clinician may ask about previous pregnancies, medicines, past infections and how long you have been trying. Bring what you know and say where dates are approximate.

The tests offered depend on your circumstances. A semen analysis looks at sperm numbers, movement and shape. A progesterone blood test can help assess whether ovulation has happened, with timing based on your periods. Other checks may assess the womb or whether the fallopian tubes are open.

Ask what each proposed test is looking for, what preparation it needs and who will explain the findings. A useful final question is: “If this does not explain the delay, what happens next?”

Leave with a next step

An assessment does not commit you to a particular treatment. CDC guidance says decisions about care take your treatment preferences into account, along with your age, the cause and how long you have had difficulties. Ask for the options and take the time you need to discuss them.

Before leaving, write down whether you are waiting for a test, a follow-up appointment or a referral. Ask who to contact if you have not heard back, and raise any concerns you haven’t yet had a chance to discuss.