How quickly should I expect to get pregnant?

Fertility problems are becoming increasingly common and approximately 1 in 7 heterosexual couples have difficulty getting pregnant. The time it takes to conceive can vary significantly and is mainly determined by a woman’s age. Over 80% of couples having regular intercourse every 2-3 days would expect to conceive with 1 year in women under 40 years and 90% of couples should have conceived within 2 years.


When should I see a fertility specialist?

We believe that women should feel empowered to seek help and advice at any stage of their fertility journey. The NICE fertility guidelines suggest that couples should be referred to a fertility specialist after 1 year of trying to conceive. If you are over 35 or have underling gynaecological conditions which may affect the chances of getting pregnant (such as endometriosis, polycystic ovarian syndrome, previous pelvic inflammatory disease) you should be offered earlier referral.

For many women, experiencing delays in getting pregnant can be deeply distressing and so we provide a fertility assessment service for whatever stage of your fertility journey you are at.  Whether you are single or in a relationship, actively trying to conceive or not, we can look at all the different aspects of your fertility and can provide you with fertility advice and further investigation or treatment if required.


What are the most common causes of infertility?

  • Ovulation problems – if eggs are not being produced regularly each month (for example due to polycystic ovarian syndrome or low ovarian reserve).
  • Tubal blockage– if the fallopian tubes are damaged or blocked the eggs and sperm will have difficulty reaching each other. This can happen due to previous pelvic infection, or adhesions (scar tissue) from previous surgery or endometriosis.
  • Sperm – low numbers or poor quality sperm will reduce the chances of conceiving.
  • Uterine (womb) problems – for example fibroids or uterine adhesions (scarring) from previous surgery or infection.

What does a fertility assessment involve?

First of all we will begin by going through your medical history including lifestyle and sexual history. If you have a partner it is helpful for them to be present as their medical history is also important. Depending on factors identified during the medical history we may suggest further investigations including:

  1. Semen analysis – this looks at the number, shape and movement of sperm. 
  2. Pelvic ultrasound – this can look for any structural problems in the womb such as fibroids or endometrial polyps, it can also count the number of the follicles visible in the ovaries (antral follicle count) which is an estimate of ovarian reserve.
  3. Ovarian reserve testing – Anti-müllerian hormone levels (AMH) is currently the best test for estimating ovarian reserve. This is a blood test that can be done at any point in the cycle.
  4. Ovulation testing – this is usually done by measuring the hormone progesterone which is produced by your ovary after you ovulate. This needs to be done on day 21 of a day 28 cycle but will vary depending on your cycle length. 
  5. Tubal testing – this can be done by x-ray or ultrasound. It involves injecting fluid into the womb and gives important information about the shape of the womb and whether the fallopian tubes appear to be open or blocked. Occasionally tubal testing is done at laparoscopy
  6. Hormone testing – depending on your medical history a number of other hormone tests could be suggested including FSH (follicle stimulating hormone), LH (luteinising hormone), testosterone, thyroid function, prolactin.

If you proceed with investigations we will then usually suggest a follow up appointment to go through the results of the tests and discuss treatment options.


What else should I be doing while I am trying to get pregnant?

There are a number of important things that you can be doing preconceptually to help you conceive naturally and reduce the chances of pregnancy complications:

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