Fertility treatment: clear options and what to try first

About 1 in 6 couples will face trouble getting pregnant. That sounds scary, but there are clear steps you can take, tests that pinpoint the cause, and treatments that work for most people. This page helps you know what to do next — without confusing jargon.

Common tests and when to see a specialist

If you’re under 35 and trying for a year with no pregnancy, see a fertility doctor. If you’re 35 or older, check after six months. See a doctor sooner if you have irregular or no periods, known pelvic infection, prior chemotherapy, or a partner with sperm problems.

Typical first tests:

• Semen analysis for the male partner — it’s quick and often tells a lot.
• Ovulation check for the female partner — track cycles, measure progesterone in the luteal phase, or use ovulation kits.
• Hormone blood tests (AMH, FSH, LH, TSH, prolactin) to check ovarian reserve and basic endocrine health.
• Pelvic ultrasound to look at ovaries and uterus.
• Hysterosalpingogram (HSG) to test whether the fallopian tubes are open.

Practical treatment steps: from simple to advanced

Start with the basics: time sex around ovulation, stop smoking, cut excess alcohol, keep a healthy weight, and treat underlying health issues like diabetes or thyroid problems. These steps help both partners and are worth doing before medical treatment.

Medication options come next. Oral drugs such as clomiphene or letrozole can help trigger ovulation if you’re not ovulating regularly. After ovulation, many women get short courses of progesterone support to help the uterine lining — our site has a clear article on progesterone’s role if you want to read more.

If ovulation drugs don’t work, or if there are sperm issues or unexplained infertility, intrauterine insemination (IUI) is a low‑to‑moderate step up. It places processed sperm directly into the uterus at ovulation to improve chances.

In vitro fertilization (IVF) is the most effective option when simpler approaches fail, when tubes are blocked, or when embryo-level testing is needed. IVF involves stimulating the ovaries, retrieving eggs, fertilising them in the lab, and placing embryos back into the uterus.

Surgery can help in specific cases — for example, removing scar tissue, treating endometriosis, or repairing a varicocele in men. For some couples, lifestyle changes plus a short course of treatment will do the trick; others need IVF or surgery.

What about supplements or herbal products? Some people try things like Tribulus terrestris or over-the-counter supplements. Evidence varies and some supplements interact with meds. Always check with your clinic before starting anything new.

Finally, fertility care is team work. Ask questions about success rates, costs, risks, and emotional support. Clinics usually offer counsellors and clear timelines. If you want specific reads from our site, we’ve written beginner-friendly pieces on progesterone, supplements, and male fertility topics to help you decide your next step.

Fertility treatment can feel overwhelming, but one clear plan — tests first, then a stepwise treatment approach — keeps things manageable and hopeful.