Trying to conceive: when to see a fertility specialist and first tests

Many couples worry when pregnancy does not happen in the first few months. This guide explains how long to wait, which tests usually come first and which specialist can help.

First, some reassuring facts

Getting pregnant often takes time. The UK National Health Service (NHS) says that when the woman is under 40, more than 8 in 10 couples get pregnant within a year if they have regular sex without contraception (about every 2 to 3 days). Of those who do not, about half get pregnant during the second year.

The World Health Organization (WHO) defines infertility as not getting pregnant after 12 months or more of regular sex without contraception. It is common. In a report published in April 2023, WHO estimated that about 1 in 6 people of reproductive age worldwide experience infertility at some point in their lives. WHO repeated this estimate in its November 2025 infertility guideline. Researchers in Bangladesh have noted that no national study has yet measured how common infertility is across the whole country. Local figures come mainly from smaller studies, such as studies at clinics or in selected areas.

Infertility is a medical condition. WHO says the cause can lie with the man, the woman or both, and sometimes no cause is found. MedlinePlus, a health information service of the US National Library of Medicine, says that about half of couples who cannot have children have a male fertility problem. WHO advises that both partners are checked at the same time, not only the wife.

When to see a doctor

The table below summarises advice from the US Centers for Disease Control and Prevention (CDC) and the US National Institutes of Health (NIH). The woman’s age matters most. The NHS says the fall in a woman’s fertility speeds up from her mid-30s.

Your situation	When to seek advice
Woman under 35, regular periods, no known health problems	After 12 months of trying
Woman aged 35 to 40	After 6 months of trying
Woman over 40	Soon, without a long wait
A known or suspected problem (see below)	Now, whatever your age

The NHS uses a slightly different age (36), but the message is the same: do not wait a full year if the woman is in her mid-30s or older.

See a doctor early, without waiting, if either partner has:

irregular periods or no periods
had a sexually transmitted infection (STI) or pelvic inflammatory disease (an infection of the womb, tubes or ovaries)
endometriosis or very painful periods
had more than one miscarriage
had cancer treatment
in men, undescended testicles or an injury to the testicles in the past
difficulty having sex

The CDC says that couples where the man is 40 or older are also more likely to have difficulty getting pregnant.

What can affect fertility

WHO, the NHS and the CDC describe several common causes:

Blocked or damaged fallopian tubes (the tubes that carry the egg to the womb). Some STIs, such as chlamydia, can affect fertility.
Ovulation problems, where the ovaries do not release an egg regularly
Womb problems such as fibroids or endometriosis
Sperm problems: few or no sperm, or sperm that move poorly or have an abnormal shape
Hormone problems

Smoking, heavy drinking, and being overweight can all reduce fertility. In women, being severely underweight can also affect ovulation. In men, the use of anabolic steroids (sometimes taken for body-building) can harm sperm.

Your first appointment

Go together if you can. The doctor will take a full medical and sexual history from both of you. They may ask:

how long you have been trying for a baby
whether the woman’s periods are regular, and about any unusual bleeding, discharge or pelvic pain
about past pregnancies or miscarriages
about past pelvic infections or operations
for the man, about any past injury to the testicles or penis, recent high fevers, or mumps in childhood

Honest answers help the doctor find the cause faster. The doctor may also examine both of you.

Which tests usually come first

For the man: semen analysis

A semen analysis (often called a sperm count) is one of the first tests. The man usually gives a sample by masturbating into a sterile container. MedlinePlus advises getting the sample to the laboratory within 30 minutes. The lab checks the amount of semen and the number, movement and shape of the sperm.

The lab will tell you how many days to go without ejaculating before the test. Follow its instructions. Sperm production can vary over time, so more than one sample may be needed. An abnormal result does not always mean there is a problem.

For the woman: blood tests

A progesterone test checks whether you are ovulating (releasing an egg). The day of the test depends on your cycle. In a regular 28-day cycle it is often around day 21, and the day is adjusted if your cycle is longer or shorter.
Early-cycle hormone tests, done in the first few days of your period, can measure hormones such as FSH and LH, which control the ovaries.
A rubella (German measles) immunity test checks whether you are protected, which matters for a future pregnancy.
Women over 35 may be offered an ovarian reserve test, which estimates how many eggs remain.
You may have other hormone or infection tests, including STI tests, depending on your medical history.

Ultrasound scan

An ultrasound scan checks the ovaries, womb and fallopian tubes. It can show conditions that may prevent pregnancy, such as fibroids.

Checking the fallopian tubes

Checking whether the tubes are open is often part of the first tests. One common test is a hysterosalpingogram (HSG), an X-ray test that can show blocked tubes. Your specialist will explain which test suits you.

Warning signs: get urgent care

Fertility tests are not emergencies, but some symptoms are. Go straight to the nearest hospital emergency department if your period is late or a pregnancy test is positive, and you have:

pain low down on one side of the belly
vaginal bleeding or a brown watery discharge
pain at the tip of the shoulder
dizziness or fainting

These can be signs of an ectopic pregnancy (a pregnancy growing outside the womb), which needs urgent care. Symptoms usually appear between the 4th and 12th week of pregnancy. Do not wait if the pain is severe or you feel faint.

Fertility problems can also cause real emotional strain, stigma and distress. If you feel hopeless or have thoughts of harming yourself, get help the same day. Through the DGHS health helpline, Shastho Batayon (16263), you can speak to a doctor by phone 24 hours a day.

Which specialist to see

Gynaecologist and obstetrician: the usual first stop for a couple. They can ask about your history, examine you and arrange the first tests.
Fertility specialist (a doctor trained in reproductive hormones and infertility): if test results are abnormal, the woman is over 35, or you may need assisted reproduction
Urologist or andrologist (a doctor for male reproductive health): if the semen analysis is abnormal, or there are problems with the testicles, erections or ejaculation
Endocrinologist (hormone specialist): if a hormone problem, such as a thyroid problem, is found
Psychiatrist or psychologist: if stress, anxiety or low mood are affecting daily life

What treatment generally involves

Treatment depends on the cause, and your doctor decides on it. WHO describes moving step by step from simpler approaches to more complex ones. Treatment may include:

advice about fertile times and lifestyle
medicines to help ovulation
surgery for some problems
assisted reproduction, such as IUI (placing prepared sperm directly into the womb) or IVF (joining eggs and sperm in a laboratory)

On 28 November 2025, WHO published its first worldwide guideline on preventing, diagnosing and treating infertility. Fertility medicines should only be used under a doctor’s supervision.

Before your appointment

Write down the start dates of the woman’s last few periods.
Bring any earlier test reports and prescriptions for both partners.
List all the medicines and supplements you take, including body-building products.

Find a doctor

Browse Infertility doctors in Bangladesh on ratings.com.bd, with chambers and, where listed, visiting hours and phone numbers.

Sources

This article is general information, not medical advice. It was written by AI from the sources above. It did not pass the automatic check, and an administrator chose to publish it; no doctor or editor has reviewed it. For a diagnosis or treatment, see a registered doctor.