Step 4 of 6 · 6–12 months without success
Step 4: Investigate
Six to twelve months without a pregnancy is the point to test both partners. Here is what to test, at home and with a doctor.
ASRM recommends a fertility evaluation after 12 months of trying if you are under 35, after 6 months at 35 or older, and sooner over 40 or with irregular periods or known conditions. Test both partners: male factors contribute in about half of couples. At-home tests are a start, not a diagnosis.
Conditions
Endometriosis and Fertility: What Helps You Get Pregnant
Endometriosis affects about 10% of women and up to half of those with infertility. How it affects fertility, what ESHRE recommends, and when to see a specialist.
Getting Pregnant After 35: Your Chances and Your Timeline
Getting pregnant after 35: what studies show about monthly and yearly chances, why ACOG and ASRM say to get evaluated after 6 months, and what you can do now.
Getting Pregnant After 40: What the Evidence Says
Getting pregnant after 40: the natural odds per cycle and per year, why ACOG and ASRM advise immediate evaluation, and how IVF, donor eggs and testing fit in.
Irregular Periods and Trying to Conceive: What to Know
Irregular periods usually mean irregular ovulation. What counts as irregular, common causes, how to track ovulation, and why you can get evaluated now.
Low AMH: Can You Still Get Pregnant?
Low AMH means fewer eggs, not infertility. What the JAMA Time to Conceive study found, how low AMH changes IVF, and when a low result should speed up your timeline.
PCOS and Getting Pregnant: What Works, Step by Step
How to get pregnant with PCOS: why ovulation is the issue, why the 2023 International PCOS Guideline makes letrozole first-line, and how to track cycles.
Results explained
AMH Explained: What an Anti-Müllerian Hormone Test Can Tell You
AMH reflects how many eggs you have left, not whether you can get pregnant. What the test measures, what affects it, how IVF uses it, and when a result matters.
Semen Analysis Results Explained: What Each Number Means
Semen analysis results explained with the WHO 2021 (6th edition) reference values for volume, count, concentration, motility and morphology, and what to do next.
When to get help
Unexplained Infertility: When Every Test Comes Back Normal
Unexplained infertility affects about 30% of infertile couples. What the diagnosis means, which tests it requires, and the treatment path ASRM and ESHRE recommend.
When to See a Fertility Specialist, and What the Workup Includes
When to see a fertility specialist: after 12 months under 35, 6 months at 35+, now if over 40 or with known issues. What the workup includes for both partners.
When to get help
ASRM's practice committee says evaluation should start at 12 months of trying for women under 35 and at 6 months from age 35, with more immediate evaluation over 40.1 Don't wait that long if periods are absent or irregular, or if there is a known reason to worry: read when to see a fertility specialist.
Test both partners
Infertility is due in whole or in part to male factors in about half of couples, and the AUA/ASRM guideline calls for evaluating both partners in parallel.2 A semen analysis is the place to start, and at-home kits are an easy first step.
What at-home tests can and can’t tell you
Finger-prick hormone kits measure markers such as AMH, FSH and thyroid hormones. They can flag something to discuss with a doctor, but they cannot tell you whether you will get pregnant: see AMH explained and low AMH. If you buy a kit, check its lab certification, whether a physician reviews results, which markers it measures and the price.
Common conditions
If you know or suspect a condition, start here: PCOS, irregular periods, endometriosis, getting pregnant after 35 and after 40. When tests come back normal, unexplained infertility explains what that means and what comes next.
This page is educational and is not medical advice. Talk to a clinician about your own situation, and seek urgent care for heavy bleeding, severe pain or fainting.
Sources
- 1Fertility evaluation of infertile women: a committee opinion. American Society for Reproductive Medicine. Practice Committee, Fertil Steril 2021;116(5):1255–1265
- 2Diagnosis and treatment of infertility in men: AUA/ASRM guideline. American Urological Association. 2024 amendment; male factors in about half of infertile couples