Help if you're not getting pregnant

If you have fertility problems, you may be struggling with many difficult feelings. Complex and often painful emotions are common for people with fertility problems, those who can't have children and those having fertility treatment.

"People can feel fear, anger and guilt," says Clare Brown, chief executive of Infertility Network UK, an infertility support network. "They can feel as though they've failed. People talk about feeling less of a woman, or less of a man. Depression and anxiety are common. Fertility treatment can be an intensely stressful experience. Most of us never imagine experiencing problems with having a child. When it happens, it’s a terrible shock."

For those whose fertility problems prevent them from having children, there can be a sense of loss or grief. Brown says: "It’s almost a kind of bereavement for the child that this person expected to have. We can build our future around a plan to have children, and suddenly it's taken away.”

Not all people who experience fertility problems feel this way. The 1.5 million people affected by fertility problems have all kinds of responses, says Brown. But for those who find themselves tackling difficult emotions, there is help.

Healthtalk.org has videos of women talking about their experiences of infertility and assisted conception.

Find support

People with fertility problems may find it useful to talk to family and friends about the way they feel. For some, however, this isn’t an option. They may not want to share their problem with people who are close to them.

"We hear quite often that family and friends find it hard to empathise with fertility problems," says Brown. "They can often say unhelpful things, such as, 'Just relax and you’ll get pregnant'. Well, sometimes that just isn’t true."

Many people find that talking to other people in a similar situation is the most beneficial form of support, says Brown. Infertility UK helps people with fertility problems contact one another to share their experiences.

"People can log on to our website and talk in the forums anonymously," she says. "We also run face-to-face support groups. They can both do an enormous amount to remove the feeling of isolation." There's also a telephone helpline staffed by volunteers to provide information, support and understanding.

Support during fertility treatment

It's common to feel stressed when undergoing fertility treatment. Some people find their feelings become more difficult, and they may experience depression or anxiety. Fertility clinics have to offer counselling to all patients and should offer it before, during and after treatment.

"Couples and women shouldn’t be reserved about coming forward to see the counsellor," says Brown. "Asking for the counsellor doesn’t mean you’re not coping. It’s perfectly normal to want a chance to talk, or seek information."

If you’re dealing with fertility problems and are experiencing feelings that make it difficult to continue with your daily life, you can go to your GP or fertility clinic for help.

Your GP can talk to you about the help that’s available, which could include talking therapies, lifestyle changes or medicines. You can find out more about fertility tests.

Fertility tests

If you've tried unsuccessfully to get pregnant for a year or more through regular unprotected sex, it’s time to see your GP. If you're a woman over 35, or if you think that either partner may have a fertility problem, see your GP after six months of trying.

A fertility problem could be because you've had surgery that may have affected your reproductive organs, or because you've had a sexually transmitted infection (STI), such as chlamydia, that may have damaged your fertility.

Many couples with fertility problems go on to conceive, with or without fertility treatment.

What to expect

If you make an appointment to see your GP because you're having trouble becoming pregnant, they will ask how long you’ve been trying. If it's been less than a year or you haven’t been having unprotected sex regularly, and there is no reason to suspect you may have a fertility problem, your GP may recommend you keep trying for a while to see if you conceive naturally. Having regular sex means having sex every two or three days throughout the month. You can find out more about maximising your chances of getting pregnant.

If you've been having regular unprotected sex for more than a year, your GP may recommend a range of tests to determine what's stopping you from conceiving.

Fertility tests

This page lists some of the most common initial fertility tests. Your GP can refer you for these tests, which will usually happen in hospital or at a fertility clinic.

Sperm test

In about one-third of cases, fertility problems are due to the male partner. Sometimes, a lack of sperm or sperm that are not moving properly can cause a failure to conceive. Your GP can arrange a sperm test. The male partner will be asked to produce a sperm sample and take it for analysis, probably at your local hospital.

Blood tests to check ovulation

Levels of hormones in a woman's blood are closely linked to ovulation, when the ovaries release an egg into the fallopian tubes. Hormone imbalances can cause ovulation problems, and a blood test can help determine whether this is happening. Going through a phase of not having periods, or having irregular periods, are also signs of ovulation problems. The most common cause of ovulation problems is polycystic ovary syndrome.

Test for chlamydia

Chlamydia is the most common STI in the UK. It can cause pelvic inflammatory disease and fertility problems. Your GP can refer you for a test for chlamydia. This can be a urine test or a vaginal swab. 

Ultrasound scan

An ultrasound scan can be carried out to check the woman's ovaries, womb and fallopian tubes. In a transvaginal ultrasound scan, which takes place in hospital, a small ultrasound probe is placed in the vagina. This scan can help doctors check the health of your ovaries and womb.

Certain conditions that can affect the womb, such as endometriosis and fibroids, can prevent pregnancy from happening. The scan can also check for blockages in your fallopian tubes (the tubes that connect the ovaries and the womb), which may be stopping eggs from travelling along the tubes and into the womb.

X-ray of fallopian tubes

This is called a hysterosalpingogram (HSG). Opaque dye is injected through the cervix while you have an X-ray. The dye will help your doctors to see if there are any blockages in your fallopian tubes. Blockages can prevent eggs passing down the tubes to the womb, and so stop pregnancy occurring. 

What's next?

These tests will uncover a cause in around 80% of cases of persistent failure to become pregnant. In the remaining 20% of cases, no clear cause can be found.

Whether or not a clear cause is found, your GP can talk you through the next steps. This may include referral to a fertility clinic for further investigation or treatment. 

Healthtalk.org has articles and videos of women talking about their experiences of infertility and assisted conception.

Fertility treatments

If you’ve been trying to get pregnant for less than a year, find out how to maximise your chances of getting pregnant. Eating a healthy diet, cutting down on alcohol, keeping to a healthy weight and getting exercise can all help.

If you’ve been trying to conceive for a year or more and you're not pregnant, it’s time to see your GP. If you're a woman over 35, or if you think either of you may have a fertility problem, see your GP after six months of trying to conceive. Your GP may refer you to a fertility clinic. This will usually be in a hospital and will provide fertility treatments.

The fertility treatment that's right for you depends on a range of factors. Staff at your fertility clinic can help you choose the treatment that will give you the best chance of conceiving.

Types of fertility treatment

No single fertility treatment is best for everyone. The right treatment for you will depend on your circumstances, including the cause of your fertility problems, the age of the female partner and your medical history. Broadly speaking, fertility treatments fall into three categories.

Fertility medicines

These are usually prescribed to women. Most of the common fertility medicines, such as clomifene, are intended to help with ovulation problems. 

Surgical procedures

These include fallopian tube surgery, which can be helpful if the fallopian tubes, which lead from the ovaries to the uterus (womb), become blocked or scarred, preventing pregnancy.

Assisted conception

This can include intrauterine insemination (IUI), in which sperm is placed into the womb using a fine plastic tube. This can be helpful in cases of mild sperm problems. Assisted conception also includes IVF (in vitro fertilisation), in which sperm and eggs are mixed outside the body and put back into the womb. This can be helpful for a range of fertility problems, including more severe sperm problems and cases of unexplained infertility.

Access to fertility treatment

If you think you may be experiencing fertility problems, see your GP first. Your GP may carry out a range of tests to help identify any fertility problems. You can learn more about what to expect in fertility tests. Access to some fertility treatment, including IVF, varies throughout the country, and waiting lists are long in some areas.

Your GP can advise you on access to NHS treatment in your area.

healthtalk.org has a range of video interviews with women talking about their experiences of infertility and assisted conception.