When to get fertility help

Knowing when to ask for help is half the battle. Asking early isn’t overreacting – it’s smart. Here’s what UK and US guidance says.

The timelines

• NHS: see your GP if you haven’t conceived after 1 year of regular unprotected sex
• NHS and NICE: go sooner if you’re 36 or over – NICE says you should be offered a specialist referral when you first ask, rather than waiting a year
• Using artificial insemination (for example with donor sperm) and no known cause: NICE says to ask for assessment after 6 cycles of insemination
• ACOG (US): evaluation after 12 months if under 35, after 6 months if 35+, and sooner if over 40
• Anytime: if you have a known reason for concern

Reasons to go sooner

• Irregular or absent periods
• Very painful periods or suspected endometriosis
• Past pelvic infection or STI
• Previous cancer treatment
• Known sperm issues in a partner
• You’re in a same-sex relationship or planning to use donor sperm – a fertility clinic can talk through your options before you start
• You’ve had a miscarriage or ectopic pregnancy while trying – NICE says the clock does not restart, so the time you have already been trying still counts

What the GP might do

Expect questions about your cycles, sex, contraception history, medicines and lifestyle – for both partners. First tests often include blood tests to check hormones and ovulation, a semen analysis, and STI checks. You may then be referred to a fertility clinic for scans or tube tests.

Treatments range from medicines to help ovulation, to surgery, to IUI and IVF. In the UK, the HFEA explains every option, and NICE guideline NG257 (published March 2026, replacing CG156) sets out who should be offered what on the NHS. NICE says IVF should be offered if you are under 42 and either have a diagnosed cause that other treatments cannot fix, or have unexplained fertility problems and have not conceived after 2 years. Under 40, that means up to 3 full cycles; at 40 or 41, 1 full cycle. What your local NHS area actually funds can be different, so ask your GP or clinic what applies where you live.