When pregnancy is slow to come, questions pile up: should we wait longer? Is something wrong? Who should we turn to? Infertility is common and affects couples all over the world. It is neither a fault nor a fate.
Here are the key points to know when to see a doctor, and what to expect from a first assessment.
What is meant by infertility
The World Health Organization defines infertility as the failure to achieve a pregnancy after 12 months or more of regular unprotected intercourse. It is a disease of the reproductive system that can affect the man, the woman or both.
Talking about infertility does not mean that pregnancy is impossible. It means that tests are useful to understand what is happening and, if needed, to offer help.
The usual time before seeing a doctor
For a couple with no known problem, it is advised to see a doctor after one year of regular attempts without pregnancy.
Reproductive medicine learned societies recommend consulting sooner, after six months of trying, when the woman is 35 or older, because female fertility declines with age. After 40, it is advised to consult without waiting.
These timeframes are guidelines, not strict rules. If waiting becomes a source of worry, a consultation already helps take stock and get suitable advice.
Situations where you should not wait
Some signs justify a prompt consultation, however long you have been trying:
- very irregular cycles or no periods;
- very painful periods or suspected endometriosis;
- a history of genital infection, abdominal or tubal surgery, or ectopic pregnancy;
- repeated miscarriages;
- for the man: a history of undescended testicle, mumps after puberty, surgery, testicular injury or varicocele;
- for either partner: past cancer treatment, a chronic illness or a known abnormality.
A couple’s journey
Infertility concerns the couple, not one person. Causes may be female, male, mixed, or remain unexplained despite full tests. That is why it is important to come together, from the first appointment.
Men may be reluctant to have tests. Yet a semen analysis is simple, quick and essential: it avoids multiplying tests for the woman when the cause may lie elsewhere.
Coming together also means sharing information and decisions. Each partner can ask questions and express expectations, which helps you move forward at the same pace.
Possible causes
In women, common causes include ovulation disorders (such as polycystic ovary syndrome), tubal damage, endometriosis, some uterine abnormalities and the natural decline of ovarian reserve with age.
In men, there may be fewer sperm, reduced mobility or abnormal shape, sometimes linked to a varicocele, an infection, a hormonal disorder or lifestyle. In some couples no cause is found despite full tests: this is called unexplained infertility, and solutions exist too.
The first fertility assessment
After a detailed conversation, the doctor suggests suitable tests:
- for the woman: clinical examination, pelvic ultrasound, hormone tests to assess ovulation and ovarian reserve, and a test of tubal patency (hysterosalpingography or equivalent);
- for the man: semen analysis, completed if needed by other tests;
- for both: infection screening and a general check-up.
These tests often identify a cause and guide the next steps.
Preparing the first appointment
To save time, bring any tests already done (blood tests, ultrasounds, semen analyses), a list of your treatments and, if possible, a record of your cycles over recent months. Also write down your questions: the consultation is the right time to ask them.
What solutions next?
Depending on the results, solutions range from the simplest to the most technical: lifestyle advice, treatment of an identified cause, ovulation induction, intrauterine insemination, then in vitro fertilisation or ICSI. The strategy is discussed with the couple, step by step.
To discover all the techniques offered, see our page on assisted reproduction in Fes.
Support in Fes
The infertility journey can be trying. Being well informed, able to ask questions and feeling listened to makes a real difference. At Boudra Fertility Center, the first IVF center in Fes, Dr Najib Boudra and his team support couples with more than 30 years of experience, from the first consultation to pregnancy care.
Book an appointment in Fes
A question, a first appointment? The Boudra Fertility Center team is here to help.
Boudra Fertility Center, 7 Rue Abdelkrim El Khattabi, 30000 Fes, Morocco
Frequently asked questions
After how long should we see a doctor?
After one year of regular attempts without pregnancy, or after six months if the woman is 35 or older. Sooner in case of irregular cycles or a known history.
Does the man also need tests?
Yes. A semen analysis is part of the basic assessment. Causes can be male as well as female when a couple has difficulty conceiving.
Are fertility tests painful?
Most tests are simple: blood tests, ultrasound, semen analysis. The tubal test can be slightly uncomfortable; it is explained in advance.
Should we stop trying during the tests?
No, unless the doctor advises otherwise. You can keep trying to conceive naturally during the tests.
This article is for information only and does not replace a consultation. For any question about your situation, talk to your doctor.