What are the first steps when trying to conceive?
If you're beginning to try for a baby, start with the basics.
Understanding your menstrual cycle and fertile window can help you identify when conception is most likely. It can also be helpful for both partners, where applicable, to consider general health factors such as smoking, alcohol, nutrition, medications and existing medical conditions.
You do not need to begin fertility treatment simply because you're thinking about fertility. For many people, the first step is simply understanding their reproductive health and knowing when it may be appropriate to ask for help.
When should I seek fertility help?
As a general guide, fertility evaluation is commonly recommended after around 12 months of regular unprotected intercourse if the woman or egg-producing partner is under 35, or after around 6 months if aged 35 or over.
However, there are circumstances where seeking advice earlier may be appropriate. These can include:
- Irregular or absent periods
- Known or suspected endometriosis
- Previous pelvic surgery
- Previous ectopic pregnancy
- Known tubal problems
- Polycystic ovary syndrome or other ovulation concerns
- Known or suspected male fertility problems
- Certain genetic or medical conditions
- Recurrent pregnancy loss
- Previous cancer treatment or other treatment that may affect fertility
- Concerns about age or reproductive health
If something doesn't feel right or you have a known fertility risk factor, it is reasonable to seek medical advice earlier — you do not have to wait 6 or 12 months.
What happens during a fertility assessment?
A fertility assessment is designed to build a clearer picture of factors that may be affecting conception. There is no single fertility test that can tell someone whether they can or cannot have a baby.
Depending on individual circumstances, initial fertility investigations may include:
- Medical and reproductive history
- Menstrual-cycle assessment
- Hormone blood tests
- Ovulation assessment
- Ultrasound
- Ovarian reserve assessment such as AMH
- Assessment of the uterus and ovaries
- Tubal investigations where appropriate
- Semen analysis
- Further tests where medically indicated
Fertility should be considered as a couple or individual reproductive-health picture, rather than focusing automatically on one partner.
AMH is not a simple test of overall fertility. It provides information about ovarian reserve and must be interpreted alongside age, medical history and other clinical information.
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Fertility is about both partners
Where applicable, fertility should be assessed as a couple. Male and female reproductive factors can both contribute to difficulty conceiving, so investigating only one partner can delay understanding what is actually happening.
Initial assessment commonly includes hormone and ovulation testing, ultrasound and semen analysis, with further investigation where appropriate.
If you're struggling to conceive, understanding why matters
If pregnancy isn't happening, the next step isn't automatically IVF.
A fertility assessment can help identify factors that may be affecting conception and help you and your healthcare professional understand which next steps may actually be appropriate.
Depending on your circumstances, investigations may look at:
Ovulation & hormones
Are you ovulating regularly and are there hormonal factors that could be affecting conception?
Ovarian reserve
Tests such as AMH and ultrasound can provide information about ovarian reserve, although they cannot on their own tell you whether you can or cannot become pregnant.
Uterus & fallopian tubes
Investigations may look for structural factors, fibroids, polyps, endometriosis or whether the fallopian tubes are open.
Sperm
Semen analysis can assess factors including sperm concentration, movement and shape.
Medical & reproductive history
Previous pregnancies, pregnancy loss, surgery, infections, medications, medical conditions and family history can all help inform an assessment.
Further investigation
Additional tests may sometimes be recommended depending on individual circumstances.
Understand the possible cause before assuming the treatment.
A clearer diagnosis or fertility assessment may help identify whether you need treatment at all — and, if you do, which treatment may be most appropriate.
Sometimes investigations identify a clear cause. Sometimes several factors contribute. And sometimes fertility remains unexplained even after standard testing.
Which route are you exploring?
You may already know which fertility treatment or route to parenthood you're considering. Explore the options below to understand what they involve, who they may be considered for, costs and what to ask before taking the next step.
You don't need an infertility diagnosis to belong here. People use fertility treatment because of infertility, fertility preservation, genetics, solo parenthood, LGBTQ+ family building, donor conception or other circumstances.
Trying to Conceive / Ovulation Support
Not everyone experiencing fertility difficulties needs IVF. Depending on diagnosis and circumstances, some people may be advised to keep trying naturally, track ovulation, treat an underlying condition or use ovulation induction.
Who might consider this?
This depends entirely on the underlying fertility assessment. Possible situations can include:
- recently started trying to conceive
- ovulation-related fertility problems
- certain hormonal conditions
- treatment of an underlying condition
- circumstances where a specialist advises that IVF is not currently necessary
IUI
IUI places prepared sperm directly into the uterus around the time of ovulation.
Who might consider IUI?
IUI may be considered in circumstances including:
- using donor sperm
- solo parenthood using donor sperm
- female same-sex couples using donor sperm
- some unexplained fertility situations
- certain sexual or physical difficulties with intercourse
- other circumstances where a specialist considers IUI appropriate
IVF
Eggs are collected and fertilised with sperm in a laboratory before an embryo is transferred to the uterus.
Who might consider IVF?
IVF may be considered in circumstances including:
- blocked or damaged fallopian tubes
- some ovulation problems
- some male fertility factors
- endometriosis
- unexplained infertility
- unsuccessful previous treatments
- where donor eggs or donor sperm are being used
- where embryo genetic testing is required
- some LGBTQ+ and solo-parent family-building pathways
Individual circumstances determine whether IVF is appropriate.
ICSI
ICSI is a laboratory technique in which a single sperm is injected directly into an egg as part of IVF treatment. It is not simply a 'better' form of IVF — it is used in particular circumstances.
Who might consider ICSI?
ICSI may be recommended where:
- sperm count is very low
- sperm movement is poor
- sperm morphology is significantly abnormal
- sperm has been surgically retrieved
- previous IVF resulted in failed or very low fertilisation
- particular male fertility factors are present
Egg Freezing
Egg freezing allows eggs to be collected and stored for possible use in future fertility treatment. It preserves an opportunity for future treatment, but does not guarantee a future baby.
Who might consider egg freezing?
Egg freezing may be considered by someone who:
- isn't ready to try for a baby now but wants to explore preserving fertility
- is concerned about age-related fertility decline
- is about to undergo medical treatment that could affect fertility
- has a medical condition that could affect future fertility
- wants to preserve eggs before certain gender-affirming treatment
- wants more information about future reproductive options
Donor Egg IVF
IVF using eggs donated by another person.
Who might consider donor eggs?
Donor egg IVF may be considered in circumstances including:
- very low ovarian reserve
- premature ovarian insufficiency
- age-related egg-quality concerns
- certain genetic conditions
- repeated unsuccessful treatment using one's own eggs
- where someone cannot use their own eggs
Donor Sperm
Donated sperm can be used in IUI or IVF to help someone build their family.
Who might consider donor sperm?
Donor sperm may be considered by:
- people affected by severe male-factor infertility
- people where there is a risk of transmitting certain genetic conditions
- solo mothers
- female same-sex couples
- people who otherwise require donated sperm to conceive
Embryo Donation
Donated embryos can provide another route to pregnancy and parenthood.
Who might consider embryo donation?
Embryo donation may be explored where:
- neither intended parent's eggs or sperm can be used
- previous fertility treatment using own eggs or sperm has been unsuccessful
- genetic considerations affect the use of own eggs and sperm
- someone wishes to explore donor conception as a route to parenthood
Reciprocal IVF / Shared Motherhood
One partner provides the eggs and the other carries the pregnancy.
Who might consider reciprocal IVF?
This may be explored by female same-sex couples where:
- one partner wants to provide the eggs
- the other wants to carry the pregnancy
- both partners wish to participate biologically in the fertility journey
Surrogacy
Surrogacy is a route to parenthood in which another person carries a pregnancy for the intended parent or parents. Surrogacy laws vary significantly between countries.
Who might consider surrogacy?
Surrogacy may be explored by:
- people who cannot safely carry a pregnancy
- people without a uterus
- some people who have experienced recurrent pregnancy loss or repeated implantation failure
- male same-sex couples
- some solo intended parents
- people with particular medical circumstances
Surrogacy law, eligibility and parental rights differ considerably between countries — always check country-specific rules and take legal advice.
Not sure which of these applies to you?
You don't need to choose a fertility treatment yourself. Your medical history, fertility investigations, circumstances and family-building goals can all affect which options may be appropriate.
Build My Fertility Journey
What should I expect at my first fertility appointment?
Your first fertility consultation is usually an opportunity for your doctor or fertility specialist to understand your medical and reproductive history and discuss appropriate investigations or next steps.
Before your appointment, it may be helpful to gather information about:
- How long you have been trying to conceive
- Menstrual-cycle history
- Previous pregnancies
- Previous pregnancy loss
- Previous fertility treatment
- Existing medical conditions
- Previous surgery
- Current medication and supplements
- Family medical history
- Previous fertility-test results
- Relevant information about both partners where applicable
You may then be offered fertility investigations based on your circumstances.
Questions you may want to ask
- What do you think could be affecting our fertility?
- Which tests do you recommend and why?
- What will each test tell us?
- What are our possible next steps?
- Are there lifestyle or medical factors we should address now?
- At what point should we consider fertility treatment?
What fertility treatment might I need?
Not everyone who seeks fertility advice needs IVF. Treatment depends on the cause of fertility difficulties, age, reproductive history, test results and individual circumstances.
Timed intercourse / ovulation support
For some people, understanding or medically supporting ovulation may be an appropriate first step.
IUI
Intrauterine insemination places prepared sperm into the uterus around ovulation.
IVF
In vitro fertilisation involves stimulating the ovaries, collecting eggs, fertilising them in a laboratory and transferring an embryo to the uterus.
ICSI
Intracytoplasmic sperm injection involves injecting a single sperm directly into an egg and may be recommended in particular circumstances.
Donor conception
Donor eggs, donor sperm or donated embryos can provide routes to parenthood in certain circumstances.
Fertility preservation
Egg, sperm or embryo freezing may be considered by people wishing or needing to preserve fertility for the future.
The appropriate next step is individual.
Considering IVF? Start here.
Being told that IVF may be an option can bring a lot of questions. You may be wondering:
- How does IVF work?
- How long does IVF take?
- How much does IVF cost?
- What are my chances of success?
- How do I choose a fertility clinic?
- What tests do I need before IVF?
- What medications are involved?
- What happens during egg collection?
- What is an embryo transfer?
Babble Connect brings these resources together so you can explore treatment one step at a time.
How much does fertility treatment cost?
Fertility treatment costs vary significantly depending on the treatment you need, where you live and where you choose to have treatment.
The advertised cost of IVF may not represent the complete amount you eventually pay. Medication, testing, ICSI, embryo freezing, storage, genetic testing and future frozen embryo transfers can add to the total cost.
Understand and plan costs
Fertility treatment around the world
Access to fertility treatment differs considerably between countries. Rules can vary around:
- IVF access
- Public funding
- Insurance
- Age limits
- Relationship status
- LGBTQ+ access
- Solo parent access
- Donor conception
- Donor identity
- Embryo donation
- Surrogacy
- Genetic testing
If you're exploring fertility treatment locally or abroad, understanding where treatment is available and which rules apply can be an important early step.
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Considering donor conception?
Donor conception can include treatment using donor eggs, donor sperm or donated embryos.
The medical process is only one part of the decision. People may also want to understand donor screening, donor identity, costs, legal differences between countries and what donor conception could mean for their future family.
Considering egg freezing?
Egg freezing is a fertility-preservation option that allows eggs to be collected and cryopreserved for possible future use. People consider egg freezing for many different medical and personal reasons.
If you're considering egg freezing, useful questions include:
- How does egg freezing work?
- When might I consider freezing my eggs?
- How many eggs might be collected?
- What does egg freezing cost?
- How long can eggs remain frozen?
- What are the chances of having a baby using frozen eggs later?
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Male fertility matters too
Fertility is not solely a female issue. Male reproductive factors can contribute to difficulties conceiving and should be considered as part of fertility assessment where applicable.
Initial male fertility investigation commonly includes semen analysis, with further investigation recommended where appropriate.
Your free fertility planning tools
Babble Connect doesn't only explain fertility — these free tools help you plan, estimate costs and compare your options wherever you are in the world.
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Fertility journeys aren't only about medical treatment. Depending on your needs, support may include:
- Fertility clinics
- Fertility doctors
- Nurses
- Embryologists
- Male fertility specialists
- Genetic counsellors
- Fertility counsellors
- Nutritionists
- Acupuncturists
- Wellbeing specialists
- Donor banks
- Support groups
Ask a fertility expert
Questions often arise between appointments or before someone is ready to contact a fertility clinic. Babble Connect allows you to explore fertility questions and expert guidance across the fertility journey.
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Fertility first steps FAQs
What are the first steps if I'm struggling to get pregnant?
Start by considering how long you've been trying, your age, menstrual cycle, medical history and whether either partner has known fertility risk factors. A GP, reproductive-health professional or fertility specialist can advise whether fertility investigations are appropriate.
When should I see a fertility specialist?
Fertility assessment is commonly recommended after around 12 months of trying when the woman or egg-producing partner is under 35 and around six months when aged 35 or over. Earlier advice may be appropriate where there are known fertility concerns or medical risk factors.
What fertility tests are usually done first?
Initial investigations can include medical and reproductive history, blood tests, ovulation assessment, ultrasound and semen analysis. Additional investigations depend on individual circumstances.
What is an AMH test?
Anti-Müllerian hormone, or AMH, is commonly used as one indicator of ovarian reserve. It does not by itself determine whether someone can become pregnant and should be interpreted alongside age and other clinical information.
Do I need IVF if I'm struggling to conceive?
Not necessarily. IVF is one of several possible fertility treatments. The appropriate approach depends on the cause of fertility difficulties and individual circumstances.
What happens at the first fertility appointment?
A fertility specialist will usually discuss your medical and reproductive history, how long you have been trying and any known fertility concerns before recommending appropriate investigations or next steps.
How much does IVF cost?
IVF costs vary significantly according to country, fertility clinic and individual treatment requirements.
Explore the IVF Cost GuideHow do I choose a fertility clinic?
Consider factors including regulatory status, treatment expertise, laboratory experience, success-rate information relevant to your circumstances, communication, location and the realistic total cost of treatment.
Find Fertility ClinicsCan I have fertility treatment abroad?
Many people travel internationally for fertility treatment, but availability, regulation, donor-conception rules, cost and eligibility vary by country.
Explore Global IVF AccessWhere do I start if I'm considering donor eggs or donor sperm?
Start by understanding the treatment itself, donor screening, the donor-identity rules applying in your country, treatment costs and which clinics or donor banks provide the service.
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Fertility guidance from IVFbabble
IVFbabble has been helping people navigate fertility and family building since 2016, bringing together expert guidance, patient experiences, fertility education and practical support.
Babble Connect builds on that experience by bringing fertility information, planning tools, expert support and fertility providers together in one place.
Our aim is to help you understand your options, know which questions to ask and find the support you need for your next step.
Last reviewed: September 2026 · Written and edited by the IVFbabble editorial team · About IVFbabble
This page is for general information only and is not medical advice. Fertility guidelines, funding and laws differ between countries — always speak with a doctor or fertility specialist about your individual circumstances.