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Heterosexual couples

If you’re about to start fertility treatment you might feel overwhelmed by how much there is to think about. Find out what you can expect with our useful guide to the fertility journey.

Fertility treatment at a glance

  1. Over 90% of couples conceive naturally within two years. If you haven’t conceived for a year however, or you know you have a condition that affects your fertility, you should go and see your GP to discuss next steps.

  2. If you do need fertility treatment, you’ll need to consider funding. Treatment on the NHS varies considerably depending on where you live and whether you meet eligibility criteria. If you opt for private treatment this can be very expensive.

  3. There are a wide range of treatment options available depending on your situation, from fertility drugs to IVF and surrogacy. Understanding what your treatment involves, its success rates and risks will help you to feel as prepared as possible.

  4. Success rates for one cycle of IVF are around 30% and are even lower for women over 38. Even if you are entitled to, or can afford to have IVF several times there’s no guarantee it will be successful. Try and be realistic about your chances right from the start.

  5. The cost and quality of care varies widely across clinics so it’s worth shopping around. You can view patient ratings, our inspectors’ rating and success rates for every clinic through our Choose a Fertility Clinic.

  6. Most people will tell you that fertility treatment is an emotional rollercoaster. Even if you’re successful there’s the risk of having a miscarriage or the treatment simply not working. Make sure you’re getting plenty of support to help you weather the ups and downs.

Reasons for difficulties conceiving

There are a number of reasons why couples may struggle to conceive. Often it’s simply a question of time – some couples just take a little longer to get there – or improving your lifestyle by maintaining a healthy weight, stopping smoking or trying to reduce your stress levels. The vast majority of couples will conceive naturally within two years.

Find out how to boost your chances of getting pregnant on the NHS Choices website

For the minority of couples who have a medical reason for being unable to conceive naturally, there are a number of potential causes. These include ovulation disorders, infections, low sperm counts and certain medications and treatments that impact your fertility.

Find out more about the causes of infertility on the NHS Choices website

Choose a fertility clinic

Getting professional help

The first step for most people who are struggling to conceive is their GP. The National Institute for Health and Care Excellence (NICE) recommends that couples who have been having regular, unprotected sexual intercourse for a year should be offered further clinical assessment and investigation.

If you have a condition that you know affects your fertility, or you’re a woman over 36, NICE recommends that you’re offered an earlier referral for a specialist consultation.

Find out more about fertility tests on the NHS Choices website

View NICE’s guidelines for the assessment and treatment of fertility problems

If the tests indicate a fertility issue in one or both partners then you’ll need to be referred for fertility treatment on the NHS or have treatment privately.  

Costs and funding

Treatment options

In-vitro fertilisation (IVF)

Gives your doctor complete control of the conception/fertilisation process and is therefore one of the most successful treatments available for some people.

Find out more about in-vitro fertilisation

IVF options

It's possible to have IVF with fewer or no fertility drugs. These treatments include natural IVF, mild stimulation IVF and in vitro maturation (IVM).

Find out more about ivf options


If you’ve had recurrent pregnancy losses or failed IVF cycles, or if you have an absent or malformed womb you may need to use a surrogate.

Find out more about surrogacy

Other things to consider

Claire's story

"After our wedding day it felt like a bit of a strange anti-climax as we knew we couldn’t conceive naturally. When other couples might start trying for a family we thought ‘okay, now what?’"

Find out more about claire's story
A couple, sat on an ottoman, reading from a leather bound book in a meadow

Saskia's story

"We were thrilled to find we were pregnant when the first blastocyst was put back in but then I miscarried at 9 weeks, which was heart-breaking. When the second didn’t work either I was really shocked."

Find out more about saskia's story
A couple stood in a meadow in winter coats, hats and scalves. The man is holding a black umbrella.

Publication date: 13 November 2017

Review date: 13 November 2019