Many conditions that affect fertility — like endometriosis, PCOS and male factor infertility — go undiagnosed for years. Recognising the signs early gives you the best chance of getting answers, treatment and, when the time comes, a healthy pregnancy.
7–10 yrs
Average time to diagnose endometriosis
1 in 10
Women affected by PCOS globally
40–50%
Of infertility cases involve male factors
New tool
Answer a few quick questions about your cycles, medical history and how long you've been trying — and we'll suggest possible fertility factors to discuss with a clinician, tests commonly considered, and when to seek support.
Please note
These symptoms may be associated with certain fertility conditions, but they can also occur for many other reasons. This information is designed to help you better understand your fertility and is not a medical diagnosis. If you are experiencing any of these symptoms, we recommend discussing them with your GP or fertility specialist, who can arrange the appropriate tests and investigations to identify any underlying conditions that may be affecting your fertility.
Tap a symptom to see what it might mean. Any of these signs — especially several together — are worth discussing with your GP or a fertility specialist.
Tap a symptom to see what it might mean. Any of these signs — especially several together — are worth discussing with your GP or a fertility specialist.
Many fertility-affecting conditions are under-diagnosed or diagnosed late. Knowing the facts can help you push for earlier answers.
Prevalence
1 in 10 women worldwide (~190 million)
Time to diagnosis
Average 7–10 years from first symptoms to diagnosis
Key symptoms
Painful periods, heavy bleeding, pain during sex, chronic pelvic pain, bloating, fatigue
Fertility impact
Affects 30–50% of women with endometriosis; may need laparoscopy to diagnose.
Source: Endometriosis UK / WHO
Prevalence
1 in 10 women of reproductive age
Time to diagnosis
Average 2+ years — up to 70% remain undiagnosed
Key symptoms
Irregular or absent periods, acne, excess hair growth, weight gain, difficulty conceiving
Fertility impact
Most common cause of anovulatory infertility. Often responds well to ovulation induction.
Source: NHS / Verity PCOS UK
Prevalence
Estimated 1 in 5 women
Time to diagnosis
Often missed for years — commonly mistaken for endometriosis or fibroids
Key symptoms
Very heavy periods, severe cramping, enlarged tender uterus, chronic pelvic pain
Fertility impact
Can reduce implantation rates; may need MRI to diagnose.
Source: British Fertility Society
Prevalence
Up to 80% of women develop them by age 50
Time to diagnosis
Often incidental — many women never know they have them
Key symptoms
Heavy bleeding, pelvic pressure, frequent urination, back pain, painful sex
Fertility impact
Submucosal fibroids can affect implantation; usually visible on ultrasound.
Source: NHS
Prevalence
Cause 25–30% of female infertility cases
Time to diagnosis
Usually only found once fertility investigations begin
Key symptoms
Often silent — sometimes chronic pelvic pain or history of pelvic infection
Fertility impact
Diagnosed via HSG or laparoscopy. IVF often needed to bypass tubes.
Source: Mayo Clinic
Prevalence
Involved in 40–50% of all infertility cases
Time to diagnosis
Requires a semen analysis — many men delay testing by 1–2 years
Key symptoms
Often no visible symptoms. May include low libido, erection issues, testicular lump/pain
Fertility impact
Includes low count, poor motility, high DNA fragmentation. Treatable with lifestyle changes, surgery, ICSI or donor sperm.
Source: British Fertility Society
Prevalence
1 in 100 women under 40; 1 in 1,000 under 30
Time to diagnosis
Frequently delayed — symptoms often mistaken for stress or perimenopause
Key symptoms
Irregular or missed periods before 40, hot flushes, night sweats, vaginal dryness
Fertility impact
Significantly reduces natural conception chances; egg donation often needed.
Source: Daisy Network / NHS
Prevalence
Affect ~1 in 20 people; women 5–8× more likely
Time to diagnosis
Simple blood test — but often overlooked in fertility workup
Key symptoms
Fatigue, weight changes, irregular periods, hair loss, cold intolerance, mood changes
Fertility impact
Both under- and overactive thyroid affect ovulation and increase miscarriage risk.
Source: British Thyroid Foundation
Early investigation makes a real difference. These are the internationally recognised guidelines on when to seek help.
Under 35
After 12 months of trying to conceive with regular unprotected sex.
35 and over
After 6 months of trying — don't wait a full year.
Over 40
As soon as you start trying — book an initial fertility assessment.
Any age with warning signs
Straight away if you have very painful/irregular periods, previous pelvic infection, known endometriosis, testicular issues, cancer treatment history, or two or more miscarriages.
Same-sex couples & solo parents
Book a consultation as soon as you're ready to start — a specialist can advise on donor treatment, IUI or IVF pathways.
Blood tests (hormones)
AMH, FSH, LH, oestradiol, prolactin, thyroid — assesses ovarian reserve and hormonal balance.
Pelvic ultrasound
Checks the uterus, ovaries and antral follicle count.
HSG or HyCoSy
Dye or saline test to check if fallopian tubes are open.
Semen analysis
Assesses sperm count, motility and shape. Often the first male fertility test.
Sperm DNA fragmentation
Assesses genetic integrity of sperm — offered where standard analysis is normal but conception isn't happening.
Laparoscopy
Keyhole surgery — the gold standard for diagnosing endometriosis.
Find a fertility expert
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Causes of infertility explained
A deeper look at what can affect fertility.
Understanding your fertility
Detailed information on specific conditions.
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This information is for general education only and does not replace medical advice. Symptoms can have many causes — always speak to your GP, a fertility specialist or another qualified healthcare professional about your individual situation.
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