Trying to Conceive but Not Getting Pregnant? When to See a Doctor and Which Tests You'll Need
Quick answer: See a gynaecologist if you've been trying to conceive for 12 months without success and you are under 35, after 6 months if you are 35 or older, and straight away if you are over 40, have very irregular or no periods, known PCOS, endometriosis, previous pelvic surgery or infection, or if your partner has a known sperm problem. A basic fertility evaluation checks ovulation, the fallopian tubes, the uterus and a semen analysis for the male partner. Many causes are treatable with simple steps, and most couples do not need IVF.
Every month starts with hope and ends with another negative test. Meanwhile, relatives keep asking "Good news kobe?" (when's the good news?).
If you're in this place, please know two things. First, you are not alone: infertility affects a significant number of couples in India. Second, a few basic tests can usually find the reason, and many causes are very treatable.
How long does it normally take to get pregnant?
Most couples conceive within a year of regular unprotected intercourse; around 8 in 10 couples do so within 12 months. The chance in any single month is roughly 1 in 4 to 1 in 5 for a healthy young couple, so it's normal for it to take a few months.
Age matters, mainly the woman's. Fertility starts to decline gradually from the early 30s and more quickly after 35, because both the number and quality of eggs fall. That's why the "when to see a doctor" timeline is shorter after 35.
When to see a doctor
Your situation | When to seek help |
Woman under 35, regular periods | After 12 months of trying |
Woman 35 to 40 | After 6 months of trying |
Woman over 40 | Before you start, or as soon as you start trying |
Irregular, very infrequent or absent periods | Now |
Known PCOS, endometriosis, fibroids, or previous pelvic infection or surgery | Now |
Two or more miscarriages | Now |
Partner with known sperm problem, past testicular surgery or infection | Now |
Timing tip: the most fertile days are the five days before ovulation and the day of ovulation. Having intercourse every two to three days through the cycle covers this window without the stress of tracking every day.
Infertility is a couple's issue
Infertility is often wrongly treated as only a woman's problem. In reality, male factors contribute in roughly a third to half of couples. That's why evaluation should include both partners from the start. A semen analysis is a simple, inexpensive test and should never be skipped.
Common causes of difficulty conceiving
In women:
Ovulation problems: PCOS is the most common cause; thyroid disorders, high prolactin, very low or high body weight, and excessive exercise or stress can also affect ovulation.
Blocked or damaged fallopian tubes: from previous pelvic infection, tuberculosis (still an important cause in India), endometriosis or past surgery.
Endometriosis: tissue similar to the womb lining growing outside the uterus, often with painful periods.
Uterine factors: fibroids or polyps inside the cavity, scar tissue, or congenital differences in the shape of the womb.
Reduced egg reserve: with age, or sometimes earlier than expected.
In men:
Low sperm count, poor motility (movement) or abnormal shape
Varicocele (enlarged veins in the scrotum)
Hormonal problems, past infections such as mumps
Smoking, alcohol, heat exposure, obesity and some medicines, including anabolic steroids
Unexplained infertility: in some couples, all standard tests are normal. Treatment can still help.
The basic fertility tests
For her
Hormone blood tests: on day 2 to 3 of the cycle (FSH, LH, oestradiol), plus thyroid (TSH) and prolactin
AMH (anti-Müllerian hormone): a blood test that estimates egg reserve. It helps plan treatment but doesn't, on its own, predict whether you can conceive naturally
Transvaginal ultrasound: checks the uterus and ovaries, counts resting follicles, and can track ovulation
Tubal test: HSG (an X-ray dye test) or a sonography-based test to check whether the fallopian tubes are open
Other blood tests as needed: blood sugar, haemoglobin, rubella immunity
For him
Semen analysis: after 2 to 5 days of abstinence; if abnormal, it is usually repeated
Further hormone tests or a urology review only if needed
Most of these can be done within one menstrual cycle.
Treatment options, from simple to advanced
Lifestyle and timing: reaching a healthy weight, stopping smoking, cutting down alcohol, managing stress, and starting folic acid. These alone help many couples.
Treating the underlying cause: correcting thyroid or prolactin problems, managing PCOS, treating infections.
Ovulation induction: tablets such as letrozole to help you ovulate, with ultrasound monitoring to track follicle growth and time intercourse.
Surgery when needed: hysteroscopy to remove polyps, fibroids or a uterine septum; laparoscopy for endometriosis or to assess the tubes.
IUI (intrauterine insemination): washed sperm is placed directly in the uterus at ovulation. Useful for mild male factor, unexplained infertility and some ovulation problems.
IVF/ICSI: for blocked tubes, severe male factor, low egg reserve, or when simpler treatments haven't worked. Your gynaecologist will refer you to a fertility centre when this is the right step.
The goal is to use the simplest effective treatment first.
Looking after your emotional health
Trying to conceive can be lonely and stressful, and it can strain relationships. It's okay to set boundaries with relatives' questions, to talk to each other openly, and to seek support from a counsellor. Stress doesn't usually cause infertility on its own, but feeling supported makes the journey easier.
Fertility support with Dr. Ajita Mishra Digga
Dr. Ajita Mishra Digga is a gynaecologist in Kolkata with more than 10 years of experience, including infertility evaluation and treatment. Couples are seen together, tests are planned efficiently around your cycle, and every result is explained clearly, so you understand your options before choosing a treatment.
Ready for answers? Call +91 91470 67691 or book a fertility consultation. Chinar Park, Rajarhat, Kolkata.
Frequently Asked Questions
How long should we try before seeing a doctor?
See a doctor after 12 months of trying if the woman is under 35, after 6 months if she is 35 or older, and right away if she is over 40 or has irregular periods or a known gynaecological condition.
What tests are done for infertility?
For the woman, usually hormone blood tests, AMH, a transvaginal ultrasound and a test to check the fallopian tubes. For the man, a semen analysis. Further tests depend on these results.
Can PCOS cause infertility?
PCOS can make ovulation irregular, which makes it harder to conceive. Most women with PCOS can get pregnant with lifestyle changes and simple ovulation-induction treatment.
Is low AMH a sign that I can't get pregnant?
No. Low AMH means a lower egg reserve, which may affect how you respond to fertility treatment and how urgently to proceed, but many women with low AMH conceive.
Should my husband also get tested?
Yes. Male factors contribute to infertility in a large share of couples. A semen analysis is simple, inexpensive and should be done early.
Does stress cause infertility?
Stress alone is rarely the main cause, but it can affect cycles and relationships. Managing stress and seeking support helps overall wellbeing during treatment.
What is the difference between IUI and IVF?
In IUI, washed sperm is placed inside the uterus around ovulation, and fertilisation happens naturally inside the body. In IVF, eggs are collected and fertilised in a laboratory, and the embryo is transferred to the uterus.
What are the best days to get pregnant?
The five days before ovulation and the day of ovulation. Having intercourse every two to three days through the cycle covers this window well.
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