A Guide to Knowing When to Keep Trying and When to Investigate Further
Whether you’ve recently started trying to conceive or have been trying for some time, knowing when to seek fertility support can help you make informed decisions and access the right care at the right time.
If you’re trying to conceive, it can be difficult to know whether what you’re experiencing is within the normal range or whether it’s time to seek some additional support.
Whether you’re trying as an individual or with a partner, understanding when to seek advice can help you make informed decisions, avoid unnecessary delays in accessing appropriate investigations or treatment, and give you confidence in your next steps.
Many people begin trying for a baby expecting it to happen relatively quickly. When it doesn’t, it can be hard to know whether to simply keep trying or whether there may be something worth investigating.
While conception can take time, there are certain situations where seeking advice sooner rather than later may be beneficial. Understanding the current recommendations can help you feel more confident about your next steps.
How Long Should You Try Before Seeking Help?
Even when both partners are healthy, conception isn’t guaranteed each month.
The chance of conceiving during any given menstrual cycle is generally around 20-25%, even when intercourse is timed correctly.
For this reason, it is perfectly normal for conception to take several months.
In general:
- If you are under 36, it is recommended to seek fertility advice after 12 months of regular unprotected intercourse.
- If you are aged 36 or over, or have a known fertility-related condition, it is advisable to seek advice sooner rather than later.
- Earlier assessment may also be appropriate if you have irregular periods, endometriosis, recurrent miscarriage, a history of pelvic infection, or other factors that may affect fertility.
Signs That You May Benefit From Earlier Support
Irregular or Absent Periods
Regular ovulation is essential for conception. If your periods are irregular, very infrequent or absent altogether, it may indicate that ovulation is not occurring consistently.
Conditions such as PCOS, thyroid dysfunction and hypothalamic amenorrhoea can all affect menstrual cycles and fertility.
Endometriosis
Endometriosis can impact fertility in a number of ways. Symptoms may include painful periods, pelvic pain, pain during intercourse or bowel symptoms, although some women have very few symptoms at all.
If you have a diagnosis of endometriosis, or suspect you may have it, it is worth discussing your fertility plans with a healthcare professional sooner rather than later.
Recurrent Miscarriage
Experiencing a miscarriage can be devastating. While one miscarriage is unfortunately common and does not necessarily indicate an underlying problem, recurrent pregnancy loss may warrant further investigation.
Previous Pelvic Infection or Surgery
Certain pelvic infections, abdominal surgery or previous treatment involving the reproductive organs can occasionally affect fertility and may justify earlier assessment.
Known Medical Conditions
Conditions such as PCOS, thyroid disorders, diabetes and autoimmune conditions can sometimes affect fertility and are often worth addressing proactively when planning a pregnancy.
Don’t Forget Male Fertility
One of the most common misconceptions is that fertility is primarily a female issue.
In reality, male factors contribute to around half of all fertility difficulties, either on their own or alongside female factors.
A semen analysis is often one of the simplest and most informative investigations available and can provide valuable information early in the fertility journey. For this reason, it is often advisable for both partners to be assessed rather than focusing solely on female fertility factors.
What Investigations Might Be Recommended?
Depending on your circumstances, your healthcare provider may suggest investigations such as:
- Hormone testing
- Thyroid function assessment
- Vitamin D and nutrient testing
- Iron status
- Ultrasound scanning
- Ovarian reserve testing, such as AMH
- Tubal assessment, where appropriate
- Semen analysis
These tests can help identify potential barriers to conception and guide the most appropriate next steps.
Many people choose to incorporate acupuncture at this stage of their fertility journey – sometimes before investigations have been carried out, and sometimes after they’ve received results and are looking for support in understanding what they mean and considering their next steps.
Acupuncture consultations take a holistic approach, considering your medical history, menstrual cycle, lifestyle, overall health and any investigations you’ve already had. This can help identify areas that may benefit from further exploration or optimisation, while also providing dedicated time to discuss your concerns and develop a personalised plan.
For many people, simply having the opportunity to step back, review the bigger picture and feel supported can bring clarity and confidence at what can otherwise feel like an overwhelming stage of the journey.
The Takeaway
Deciding when to seek fertility support can feel like a significant step, but it doesn’t necessarily mean that something is wrong.
Sometimes investigations provide reassurance. Sometimes they identify a straightforward issue that can be addressed. And sometimes, seeking advice a little earlier simply helps you make informed decisions and avoid unnecessary delays.
If you’re unsure whether it’s the right time to seek support, speaking with an experienced fertility practitioner can help you understand your options and feel more confident about your next steps.
Whether you’re looking to optimise your fertility before trying to conceive, seeking support alongside investigations, or preparing for fertility treatment such as IVF, taking a proactive approach can help you feel informed, supported and empowered throughout your fertility journey.
Fertility Series
This article is part of our six-part fertility series, designed to provide clear, evidence-informed guidance for every stage of the fertility journey.
Read next: Are You Timing Things Correctly? A Guide to Tracking Ovulation.
About the Author
Charlotte Conwy is a fertility acupuncturist and women’s health practitioner based at the clinic. She supports individuals and couples trying to conceive naturally, as well as those preparing for and undergoing fertility treatment, including IVF.
Charlotte takes an evidence-informed, personalised approach to care, combining acupuncture with detailed assessment, education and lifestyle guidance to support patients at every stage of their fertility journey.
