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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.

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

Fertility clinic search

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 IVF

Intrauterine insemination

Not currently available on the NHS but may be offered if you’re having treatment privately. Less invasive but also less successful than IVF.

Find out more about IUI

Intracytoplasmic sperm injection (ICSI)

The main treatment for couples where the sperm is the primary cause of infertility.

Find out more about ICSI

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

Getting support

Explore the different support options available and find what works for you.

Get support
A woman standing in a forest silhouetted by the glare of a setting sun

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?’"

Read 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."

Read Saskia's story
A couple stood in a meadow in winter coats, hats and scalves. The man is holding a black umbrella.

Publication date: 9 November 2018

Review date: 9 November 2020

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