About 1 in 6 couples will face trouble conceiving at some point. That’s a lot, and it can feel confusing. This page gives a straight, step-by-step look at what tests to get, what treatments usually work first, and when to move to more advanced options.
If you’re under 35, try for a year before fertility tests. If you’re 35 or older, start testing after six months. See a doctor sooner if you have irregular periods, a history of pelvic infection, known low sperm count, or repeated pregnancy loss.
Start with basics for both partners: a semen analysis for him; for her, check ovulation, thyroid, prolactin, FSH, and AMH (ovarian reserve). An ultrasound looks at the uterus and ovaries. If tubes are a concern, your doctor may recommend a hysterosalpingogram (HSG). These tests tell you where to focus treatment.
1) Lifestyle and simple fixes. Quit smoking, get to a healthy weight, cut heavy drinking, and manage stress. Small changes can help ovulation and sperm quality.
2) Ovulation induction. For women who aren’t ovulating, doctors often try oral meds first. Clomiphene (Clomid) and letrozole (Femara) are common. Letrozole often works better for people with PCOS; studies show it can produce higher pregnancy rates in that group. If you want a full look at alternatives, read our guide “Exploring Eight 2025 Alternatives to Clomid.”
3) Metformin and hormone tweaks. Metformin helps some people with PCOS. If tests show thyroid or prolactin problems, treating those usually improves fertility quickly.
4) Intrauterine insemination (IUI). IUI places washed sperm directly into the uterus around ovulation. It’s used when sperm count or motility is mildly low, or after ovulation drugs. It’s less expensive than IVF and a common next step.
5) IVF and advanced assisted reproductive technology (ART). IVF is the go-to for blocked tubes, severe male factor, or when other treatments fail. It’s the most effective option for many issues but also the most costly and invasive.
6) Surgery and specialized fixes. Laparoscopy can remove scar tissue or treat endometriosis. For men, varicocele repair sometimes improves sperm counts. These are specific fixes based on test results.
7) Donor gametes and surrogacy. If egg or sperm quality is very low, donor eggs or sperm, or a gestational carrier, may be the best path to a child.
Want related reading? We have a practical article on spironolactone and PCOS that explains risks and dosing — useful if you’re managing hormonal acne and fertility at the same time.
How long to try each step? Most clinics will try 3–6 cycles of medicine with or without IUI before recommending IVF, but that depends on age and test results. If you’re unsure, ask a fertility specialist for a clear timeline based on your tests. Simple, specific steps beat guesswork every time.
Fertility drugs play a pivotal role in aiding women with infertility issues by stimulating ovulation and enhancing the chances of conception. These medications include clomiphene citrate and gonadotropins, which function like natural hormones. While they increase pregnancy prospects, they pose risks such as ovarian hyperstimulation syndrome and potential links to certain cancers, though no conclusive evidence supports significant long-term risks.
Callum Laird | Nov, 23 2024 Read More