What is fertility problems?
Fertility problems are usually defined as failing to conceive after a year of regular unprotected sex — or six months when the woman is over 35. Around one in seven couples in the UK is affected. Causes include ovulation disorders such as PCOS, blocked fallopian tubes, endometriosis, sperm problems and declining egg quality with age; in about a quarter of couples no cause is found. Female and male factors contribute in roughly equal measure, so both partners should be assessed together.
Investigation typically involves hormone blood tests and a pelvic ultrasound for the woman, semen analysis for the man, and tests of tubal patency where indicated. Results guide treatment, which ranges from lifestyle changes and ovulation-induction tablets to IVF.
Common symptoms
- Not conceiving after 12 months of trying
- Irregular, absent or very painful periods
- Known conditions such as PCOS or endometriosis
- Previous pelvic infection or surgery
- Recurrent miscarriage
- Erection or ejaculation problems in the male partner
How long will you wait?
NHS fertility care involves multiple pressured stages — a gynaecology referral often waits several months, and NHS-funded IVF availability then varies sharply by area, with eligibility rules and further queues that can add a year or more to the journey.
Privately, you can typically see a fertility specialist within 3–7 days, complete initial investigations for both partners within 1–2 weeks, and start treatment within weeks rather than months.
NHS England median referral-to-treatment wait: 12.4 weeks, with 2.5 million people waiting over 18 weeks (May 2026). Individual waits vary by trust and urgency.
Treatment options
- Lifestyle optimisation. A healthy weight, stopping smoking, limiting alcohol and well-timed intercourse meaningfully improve the chances of natural conception.
- Ovulation induction. Tablets such as letrozole or clomifene stimulate egg release in women who are not ovulating regularly.
- Surgery. Keyhole surgery can treat endometriosis, remove polyps or fibroids, or unblock tubes where these are the barrier to conception.
- Intrauterine insemination (IUI). Prepared sperm is placed directly into the womb around the time of ovulation, used in selected situations.
- IVF and ICSI. Eggs are fertilised in the laboratory and an embryo transferred to the womb, with ICSI adding sperm injection for male-factor problems.
What does private treatment cost?
As a guide, private fertility investigations for a couple typically cost £500–£1,000, and a single IVF cycle around £5,000–£8,000 excluding drugs, which can add £1,000–£2,500.
Does health insurance cover fertility problems?
Fertility treatment is almost never covered by UK private medical insurance — IVF, IUI and ovulation induction are standard exclusions across the market. However, investigating the underlying cause of symptoms can be covered: for example, diagnosing and surgically treating endometriosis or fibroids may fall within your policy even though any subsequent assisted conception will not. Read the fertility exclusion wording carefully.
Frequently asked questions
When should we seek help with conceiving?
See your GP after a year of regular unprotected sex without conceiving — or after six months if the female partner is over 35, since egg quality declines with age and earlier assessment preserves options. Seek advice sooner if either partner has a known issue, such as very irregular periods, previous pelvic infection, undescended testes or cancer treatment. Both partners should be tested together.
Can I get IVF on the NHS?
Possibly, but funding varies considerably across England. National guidance recommends offering IVF cycles to eligible couples, yet local integrated care boards set their own rules on the number of funded cycles, age limits, BMI and whether either partner has children from a previous relationship. Your GP or fertility clinic can confirm the criteria in your area before you decide between NHS and self-funded treatment.
How successful is IVF?
Success depends heavily on the woman's age and the cause of infertility. Nationally, birth rates per embryo transferred are highest for women under 35 and decline steadily with age, which is why clinics quote age-specific figures. Many couples need more than one cycle. When comparing clinics, look at verified success rates for your age group on the HFEA website rather than headline marketing figures.
Related guides
- Endometriosis
- Heavy Periods (Menorrhagia)
- Ovarian Cysts
- Pelvic Organ Prolapse
- Polycystic Ovary Syndrome (PCOS)
- Uterine Fibroids