In short: More than 8 in 10 couples where the woman is under 40 conceive naturally within a year of regular unprotected sex. UK advice is to see a GP if you have not conceived after about a year of trying, or sooner if the woman is aged 36 or over or either partner has a known possible fertility problem. Both partners should be assessed, as fertility problems can affect men and women.

This guide, written by a Ready Health prescribing pharmacist, explains when to seek help, what initial tests usually involve and how NHS fertility treatment works, in line with NHS information and updated NICE guidance.

How long does it usually take to get pregnant?

For couples having regular unprotected sex (every 2 to 3 days throughout the cycle), most conceive within a year and around 9 in 10 within two years. Female fertility gradually declines with age, particularly from the mid-30s, and male fertility also declines more slowly with age. Around 1 in 7 couples have difficulty conceiving.

When should you seek help for fertility problems?

Speak to a GP if:

You have been trying for a year without success
The woman is aged 36 or over, in which case it is reasonable to seek advice earlier
Either partner has a known possible cause, such as irregular or absent periods, endometriosis, previous pelvic infection, previous cancer treatment, undescended testes or past testicular surgery
You are using donor insemination or are in a same-sex relationship and want to understand your options

Ideally, both partners should attend appointments, because problems with sperm contribute in a significant proportion of couples, and in around a quarter of couples no cause is identified (unexplained infertility).

What are the common causes of infertility?

Ovulation problems, for example due to polycystic ovary syndrome (PCOS), thyroid problems or being significantly under- or overweight
Blocked or damaged fallopian tubes, for example after pelvic infection such as chlamydia
Endometriosis
Sperm problems, such as a low sperm count or reduced movement
Lifestyle factors affecting both partners, including smoking, alcohol, weight and some medicines

Anabolic steroids and testosterone treatment can switch off sperm production. Men trying for a baby should tell their clinician if they use either.

What happens at the first GP appointment?

A GP will usually ask about how long you have been trying, your periods, previous pregnancies, sexual health, medical history, medicines, and lifestyle. They may examine you and arrange initial tests, which can include:

For women: a blood test to check whether you are ovulating (progesterone, timed to your cycle), other hormone tests if periods are irregular, and checks for chlamydia
For men: semen analysis, repeated if the first result is abnormal

Depending on the results, you may be referred to a specialist fertility service for further tests, such as an assessment of the fallopian tubes and pelvic ultrasound.

What treatments are available?

Treatment depends on the cause and may include:

Medicines to help ovulation, prescribed and monitored by a specialist
Surgery, for example for endometriosis or blocked tubes
Intrauterine insemination (IUI) in some situations, such as for same-sex couples or when donor sperm is used
In vitro fertilisation (IVF), with or without intracytoplasmic sperm injection (ICSI)

What does updated NICE guidance say about IVF on the NHS?

In March 2026, NICE published an updated fertility guideline (NG257), replacing the previous 2013 guidance (CG156). It continues to recommend 3 full cycles of IVF for eligible women under 40, says further cycles may be considered if earlier ones are unsuccessful, and recommends 1 cycle for eligible women aged 40 to 41 who meet certain criteria. However, NHS funding decisions are made by local integrated care boards (ICBs), and many offer fewer cycles or have additional criteria, such as BMI, smoking status and existing children. Ask your GP about the policy in your area.

If you choose private treatment, use a clinic licensed by the Human Fertilisation and Embryology Authority (HFEA), and be cautious about paid add-ons that do not have good evidence behind them.

What can you do to improve your chances?

Take a daily folic acid supplement (400 micrograms) while trying and until 12 weeks of pregnancy; some women need a higher dose prescribed
Stop smoking, for both partners
Avoid alcohol if you are trying to become pregnant; men should keep within 14 units a week
Aim for a healthy weight
Check medicines with a pharmacist or GP, including over-the-counter and supplements
Look after your emotional wellbeing; fertility problems can be very stressful

Frequently asked questions

How long should we try before seeing a doctor?

Usually about a year, or sooner if the woman is 36 or over or there is a known possible issue.

Do both partners need tests?

Yes. Sperm problems are a common contributing factor, so semen analysis is a standard early test.

Can stress cause infertility?

Stress can affect libido and how often couples have sex, but it is rarely the sole cause. Support is still important, as trying to conceive can be emotionally difficult.

Is IVF available on the NHS?

Yes, for people who meet local criteria. The number of cycles funded depends on your ICB.

Key takeaways

Most couples conceive within a year of regular unprotected sex.
Seek advice after a year of trying, or earlier if the woman is 36 or over or there is a known issue.
Both partners should be assessed.
Updated NICE guidance (NG257, 2026) replaces CG156, but local ICBs decide NHS funding.
Folic acid, not smoking, limiting alcohol and a healthy weight all help.

Sources and further reading

Last reviewed: October 2026 by Shamir Patel, Independent Prescribing Pharmacist, Ready Health. This article is general information and does not replace advice from your own clinician.

Ready Health does not provide fertility treatment. If you would like to talk through general health concerns before or while trying to conceive, you can book a private GP appointment in Standish, Wigan. For NHS fertility investigations and referral, please speak to your registered NHS GP.