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When should one seek help for fertility problems?

This would vary depending on individual circumstances. Generally if a couple has been trying to conceive for more than a year it is likely that there is a problem contributing to their difficulties, nevertheless, 50% of couples who haven’t conceived after one year will conceive if they wait another year. It is for this reason, that the UK’s National Institute for clinical excellence (NICE) recommends waiting 2 years before undergoing treatment for fertility problems.

The problem with this approach is that for older women, particularly those women 40 years or older, the chances of conceiving decline rapidly with advancing age. Therefore waiting for 2 years when there is a major problem will result in a high chance of conception not occurring. As such, women who are older should seek help sooner. Sadly in many parts of the UK funding for fertility treatment or assessment is not funded for women over 40 years of age.

The paradox in younger women is that whilst your chances of conceiving are much better, if you haven’t conceived within a year, this does suggest there is a problem as we would expect 9 out 10 women under the age of 30 years to have conceived by then.

Nevertheless, because the ovarian reserve and egg quality of younger women (<30 years) is better, waiting longer for treatment or tests is not as detrimental as would be the case in older women.

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