As a fertility specialist, my passion and focus lie in guiding individuals and couples through their unique fertility journeys, providing expert care and support to help them conceive and build the families they dream of.
Fertility
The chance of natural conception per month is age dependent:
At age 25, the chance of natural pregnancy per month is about 25%.
At age 30, the chance per cycle is about 20%.
At age 35, the chance falls to less than 15% per month.
By age 40, natural conception drops to less than 5% per month.
Good fertility relies on both the quantity and quality of eggs in women, and sperm quality in men—both decline with age, making timing an important factor to keep in mind.
Fertility Facts by Age
Knowing when to get professional support can make a crucial difference:
Ideally seeing a specialist prior to trying to conceive can help you optimise your health and chances right from the start. Alternatively;
Under 35 years old no known risk factors: Seek fertility advice after 12 months of trying to conceive without success.
35 years or older: If conception hasn’t occurred after 6 months seek advice
Known infertility issues: If diagnosed with conditions such as PCOS, endometriosis, male factor infertility or have experienced recurrent miscarriages, consult a fertility specialist sooner—don’t wait the usual timelines.
When to Seek Help
Fertility is a team effort. Both partners’ health—physical, mental, and reproductive—is important for conception. Nutrition, weight, lifestyle (including smoking, alcohol intake), stress, and sleep quality can influence success. Male fertility is just as crucial, and comprehensive testing should include both partners.
The Importance of Both Partners’ Health
A thorough fertility assessment is the first step toward understanding what might be impacting conception. I will start by taking a detailed history from both partners to identify individual risk factors and guide testing.
Typical investigations include:
Blood tests to check hormone levels and infection and immunity status
Pelvic ultrasound to assess the uterus, ovaries, fallopian tubes, and to look for polyps, cysts, fibroids, or structural issues
Semen analysis to examine sperm count, motility, and morphology which can dictate which treatments are suitable
Screening tests: cervical screening should be up to date. Genetic screening will be offered to assess for conditions which you do not have yourself but could potentially pass on to a child. if applicible mammograms should be current
Fertility Assessment
Optimising health before starting any fertility treatment is important:
Take a prenatal supplement with folic acid and iodine
Engage in regular physical activity and maintain a healthy body weight
Eat a varied, nutrient-rich diet—especially one with anti-inflammatory properties, like the Mediterranean diet
Avoid processed and packaged foods
Limit caffeine to a maximum of 200mg per day
Reduce or avoid alcohol and abstain from smoking, vaping, and recreational drugs.
Check that any medications are safe for conception and adjust or optimise management of health conditions like high blood pressure or diabetes.
Verify health insurance and benefits to understand financial support options.
Support is essential: many find it helpful to engage with a clinic counsellor, and lean on friends and family for emotional guidance.
Preparing for Treatment
Fertility Treatment Options
This is the most simple of treatments and is recommended for those who do not ovulate regularly. This involves hormonal medication taken orally or by injection to stimulate the ovaries to produce and release an egg. Ultrasound and blood tests are used to help identify the best timing for intercourse to occur.
Ovulation Induction (OI)
IUI also utilises ovulation induction and then places prepared sperm directly into the uterus through a small catheter. This technique can improve chances where there are mild male factor issues, sexual dysfunction, unexplained infertility, or when using donor sperm. Success rates depend on individual circumstances but are typically higher than natural conception but lower than for IVF per cycle.
Intrauterine Insemination (IUI)
IVF involves hormone medications which stimulate the ovaries to produce a number of mature eggs (rather than one per cycle as with natural ovulation). Scans are performed to identify the perfect time for egg collection which is performed under sedation through a transvaginal scan probe with a small needle which passes through the top of the vagina to the ovaries where eggs are retrieved through aspiration of the fluid surrounding them in the ovaries. Following this the eggs are either placed with or injected with (ICSI) sperm and the following day they are checked for fertilisation.
Any fertilised eggs which continue to grow can form embryos which can either be placed into the uterus a few days after egg retrieval or following the next bleed if a “freeze all” approach is used.
In some circumstances people may elect to have their embryos tested for genetic abnormalities prior to transfer.
Following embryo transfer a blood test is taken around 10 days later to detect if implantation, and pregnancy, has occurred. In this time progesterone support will be given to aid in this process.
In Vitro Fertilisation (IVF)
In some cases surgery may be recommended for diagnosis or treatment and this will depend on your symptoms, wishes and test results. Conditions often treated with surgery include endometriosis, fibroids and polyps. See the seperate section on surgery for more information.
Surgery
Navigating fertility challenges can be complex. Emotional support—through clinic counsellors, peer groups, and loved ones—helps manage stress and improves overall wellbeing throughout treatment.
Support Matters
Taking the First Steps
Start by booking a comprehensive fertility assessment. Bring any relevant investigations and information on any health conditions and medications being used. If treatment has been attempted previously details around this are very useful. An appointment does not commit you to treatment and sometimes small changes and advice are all that is needed.