WOMEN’S HEALTH
Fertility Health — When to Seek Advice
A practical guide to when fertility advice is worth seeking, what a first consultation may cover, and why early assessment can be more helpful than waiting.
Fertility concerns are often emotionally loaded, but the medical starting point is usually practical and structured. The first clinical questions are straightforward: how long have you been trying to conceive? Are cycles regular? Is there a history of PCOS, endometriosis, pelvic infection, miscarriage, thyroid disease, or other factors that could influence the picture?
Many women are not looking for a fertility clinic immediately. They want an informed first discussion, help deciding whether timing is still within the expected range, and clarity on whether any early assessment would be useful. The broader women’s health hub covers the wider service.
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When fertility advice is worth seeking
NICE guidelines suggest that couples who have been trying to conceive for 12 months without success should be offered investigation. However, earlier assessment — at 6 months or sooner — is appropriate for women over 36, for women with known or suspected conditions such as PCOS, endometriosis, previous pelvic infection, or a history of ectopic pregnancy or miscarriage, and for women with irregular or absent periods. Earlier assessment is also sensible when there are known male factor concerns or when the couple is anxious and wants a clearer understanding of where they stand.
Initial assessment
What a first consultation may cover
Initial assessment typically covers menstrual history and cycle regularity, sexual health screening where appropriate, general medical history and medication review, smoking, alcohol and weight, and relevant blood tests — which may include day 2–5 hormonal profile (FSH, LH, oestradiol, AMH), thyroid function, prolactin, and rubella immunity. Male factor accounts for roughly a third of fertility difficulties, so semen analysis should be considered early rather than treated as a last resort.
Same-day appointments available. Book online or call 020 7736 7557.
Next steps
Referral and preconception review
Where initial results suggest a specific issue, referral to a fertility specialist can be arranged. In some cases, a broader preconception review — including health checks, folic acid supplementation, medication review and lifestyle optimisation — is the most useful starting point. Fertility advice is often most helpful before worry becomes overwhelming.
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