Fertility medicine covers the investigation and treatment of difficulty conceiving, together with options such as egg freezing and treatment with donor eggs or sperm. Either partner can be affected, so the first task is to look for the cause in both, because the right next step for blocked fallopian tubes, irregular ovulation or a low sperm count is not the same.1
In short
The NHS suggests seeing a GP after a year of trying without conceiving, or sooner for women aged 36 and over and anyone who already knows of a possible fertility problem.1 Basic tests in both partners usually come before any decision about in vitro fertilisation (IVF). In about a quarter of cases no cause is found.1 Age, the underlying cause and individual test results shape the options far more than the choice of clinic or add-on.
What this field covers
- Fertility investigations: tests of ovulation and ovarian reserve, checks of the womb and fallopian tubes, and semen analysis.
- Medicines and surgery: medicines to help regular ovulation, and surgery for problems such as endometriosis or damaged tubes.1
- Assisted conception: intrauterine insemination (IUI, placing prepared sperm inside the womb) and IVF, where eggs are fertilised outside the body, sometimes with intracytoplasmic sperm injection (ICSI, injecting a single sperm into an egg).
- Donor treatment and fertility preservation: donor eggs or sperm, and freezing eggs, sperm or embryos.
Start with the cause
| Concern or symptom | Possible causes | Usual first step / type of specialist |
|---|---|---|
| Not conceiving after a year of regular unprotected sex | Ovulation problems, blocked or damaged fallopian tubes, endometriosis, poor semen quality, or no identifiable cause1 | GP assessment of both partners, then referral to a fertility specialist |
| Irregular or absent periods | Irregular ovulation, being severely underweight, hormonal conditions; some of these respond to medicines or weight change alone1 | GP blood tests; gynaecology or fertility clinic |
| Painful periods or pelvic pain with difficulty conceiving | Endometriosis, pelvic infection in the past, other pelvic conditions | Gynaecologist; imaging and sometimes surgery |
| Concern about semen quality | Smoking, heavy drinking, exposure to some pesticides, solvents or metals, medical conditions1 | Semen analysis; urology or andrology review if abnormal |
| Wanting to delay pregnancy | Natural decline in fertility with age1 | Fertility specialist to discuss egg freezing and its limits |
Main types of option
| Option | What it can do | What it cannot do |
|---|---|---|
| Continuing to try, with lifestyle changes | Stopping smoking, reducing alcohol and reaching a healthier weight can improve fertility1 | Cannot overcome blocked tubes or very low sperm counts |
| Medicines or surgery | Can restore ovulation or treat endometriosis or tubal problems1 | Help only when the specific cause responds to them |
| IUI | Places sperm closer to the egg; may be used with donor sperm | Suits a narrower set of situations than IVF; suitability depends on test results |
| IVF, with or without ICSI | May be recommended when there is difficulty getting pregnant and other treatments have not worked4 | Success depends on the cause, age, body mass index (BMI) and lifestyle; a live birth is not assured4 |
| Treatment add-ons | Optional extras offered on top of routine treatment2 | Amber or red ratings from the regulator mean evidence of improving live birth rates is conflicting or absent2 |
| No treatment | A legitimate choice, including after unsuccessful cycles | Does not change the underlying cause |
What cannot be decided online
An online questionnaire cannot tell whether the tubes are open, whether ovulation is happening, or whether a semen sample is normal. These need blood tests, ultrasound, tubal assessment and laboratory semen analysis, interpreted together and sometimes repeated. A single test result, such as an AMH (anti-Müllerian hormone) level, is one piece of the picture rather than a verdict on the chance of pregnancy.
The treatment plan, medicine doses, the number of embryos to transfer and whether any add-on is reasonable all depend on that assessment. The HFEA advises that a clinic should provide the evidence of effectiveness for any treatment it offers.2 Laws on donation, embryo storage and testing also differ between countries, which matters for anyone considering treatment abroad.
When to seek urgent medical help
The HFEA advises contacting the clinic immediately during or after fertility treatment for:3
- a swollen stomach and stomach pain, nausea and vomiting, shortness of breath, faintness or passing less urine, which can be signs of ovarian hyperstimulation syndrome (OHSS); severe OHSS can be life-threatening
- one-sided low abdominal pain, vaginal bleeding or dark brown discharge, or pain when going to the toilet, which can be signs of an ectopic pregnancy
Guides in this section
Related guides elsewhere: what a treatment quote should include and how to verify a doctor’s credentials.
Common questions
- What Does an AMH Test Tell You?
- What Does a Semen Analysis Show?
- IVF vs IUI: What Is the Difference?
- What Is ICSI?
- How Does Age Affect IVF Success?
- How Many IVF Cycles Might Be Needed?
- Do IVF Add-Ons Work?
- What Is PGT-A, and Does It Improve IVF Outcomes?
- What Is Ovarian Hyperstimulation Syndrome (OHSS)?
- Why Do Clinics Recommend Single Embryo Transfer?
- What Should You Know About Egg Freezing?
- How Do Fertility Laws Differ Between Countries?
Sources
- NHS. Infertility. NHS website. https://www.nhs.uk/conditions/infertility/. Accessed 5 November 2026.
- Human Fertilisation and Embryology Authority. Treatment add-ons. HFEA. https://www.hfea.gov.uk/treatments/treatment-add-ons/. Accessed 5 November 2026.
- Human Fertilisation and Embryology Authority. Risks of fertility treatment. HFEA. https://www.hfea.gov.uk/treatments/explore-all-treatments/risks-of-fertility-treatment/. Accessed 5 November 2026.
- NHS. IVF. NHS website. https://www.nhs.uk/tests-and-treatments/ivf/. Accessed 5 November 2026.