In the UK, as many as one in seven couples will experience difficulties in naturally conceiving a child. Unfortunately, many people don’t realise there is a problem with their fertility until they start actively trying to get pregnant.
If you have any concerns around your own fertility, it’s better to know sooner rather than later. Whether you’re planning for the future or trying for a pregnancy now, you’re in the right place to learn the key signs to look out for and when to see a specialist about your fertility.
Infertility is diagnosed when a person has not fallen pregnant within a year of trying, despite having regular unprotected sex (every 2-3 days).
For same-sex couples or single people, this definition is expanded to:
Not becoming pregnant after 12 cycles of artificial insemination
Not being able to conceive using your own gametes (egg or sperm cells)
Fertility challenges can be hard to spot, for all sorts of reasons. They can be masked by contraception, go unnoticed, and sometimes, there simply are no symptoms.
But there are a handful of warning signs that should always prompt a visit to your doctor.
Being able to recognise these signs means you can get the advice, tests, lifestyle tips or treatments that can help get your plans for parenthood back on track.
For people who plan to carry a pregnancy, many symptoms of infertility relate to their periods. The menstrual cycle acts a ‘vital sign’. It’s a helpful readout from your body that can let you know if your reproductive system is working as it should.
We recommended you see a doctor or speak to a fertility specialist if you are experiencing any of these signs:
Irregular or unpredictable periods
Absent periods
Spotting or breakthrough bleeds in between periods
Periods more than 35 days apart, or less than 25 days apart
Very painful periods
Pain during intercourse
Although these don’t always mean infertility, they can be signs of conditions affecting fertility, like endometriosis, PCOS, early menopause or premature ovarian insufficiency.
If you’re using contraception, such as the IUD or the pill, these can mask symptoms relating to your menstrual cycle, for example, irregular or painful periods.
Sadly, a regular period is no guarantee of being fertile - only a fertility assessment can explore that. But if your periods are unpredictable, absent, or painful to the point that they interfere with your life, it’s time to speak to a doctor about possible fertility challenges.
Your cycle is regular when your periods are spaced apart evenly, meaning they always happen a similar number of days apart. On average, day one of the period comes every 28 days.
Most people have a total menstrual cycle lasting 25 - 35 days, which includes five to seven days of bleeding. If your total cycle is longer or shorter, it can be a sign of an underlying fertility condition.
Learn more about female infertility, including the symptoms, possible causes, and what’s available to help if you’re worried about your fertility.
For people who plan to start a pregnancy by contributing healthy sperm, the signs of infertility can be a little harder to spot.
Male factor infertility doesn’t often cause symptoms. The most common cause of male infertility is poor sperm quality, and the only way to tell is by checking your sample under a microscope — known as semen analysis or a sperm test.
But, if you’re experiencing any of the following signs, it’s time to see a doctor about your fertility:
Difficulty getting or keeping an erection
Little to no interest in sex
Dry orgasm (where no semen comes out)
Cloudy urine
Breast growth (gynecomastia)
Although these don’t always mean infertility, they can be signs of male infertility, or conditions that could cause it.
You’ve likely heard of testosterone, which is a hormone that’s closely linked to sperm production.
Low testosterone is more common in people with low-quality sperm and can cause erectile dysfunction, a low sex drive, and symptoms like gynecomastia and muscle weakness.
But before you consider the possibility of testosterone supplements to help this, you’ll want to know that these can lower your sperm count - so much so that clinical trials are exploring whether they could work as male birth control.
Other symptoms of male infertility, like dry orgasm or cloudy urine, can be caused by blocked tubes or being unable to produce sperm, for example, after a medical treatment like chemotherapy.
Learn more about what can cause male infertility and ways to help you on your pathway to parenthood.
The biggest factor affecting fertility is age.
For people who can carry a pregnancy, they’re most fertile during their teens and twenties, gradually declining from the age of 30. Fertility falls more quickly from age 35, until you reach menopause.
For people who make sperm, the window of fertility is longer. There’s no exact cut-off date for male fertility, though sperm quality does decrease with age.
All this means is that if you’re trying for a baby at an age where fertility may be a concern (age 35+), or planning to, you may want to speak to a fertility specialist to find out if you might need any extra help getting pregnant.
Generally, fertility specialists recommend having a fertility assessment if:
You’ve been trying for more than one year
You’re over 35 and have been trying for more than six months
You’re over 40 and want to try
Receiving personalised medical advice early on in your journey saves you losing precious time, so that you can go forward armed with insights from your results – whether that’s lifestyle changes, more tests, or treatment.
Certain lifestyles could be considered a warning sign for your fertility, now and in the future.
The good news is that many of these are within your control, especially with the support of a fertility specialist.
So, if parenthood is in your plans, experts usually recommend:
Drinking less alcohol – staying within the recommended limits, and aiming to be alcohol-free when you’re actively trying to conceive
Quitting smoking - no amount of cigarette smoke is considered ‘safe’ for fertility
Getting or staying within your healthy weight range - being overweight, obese, or underweight can impact egg and sperm production
Discover more doctor-backed tips for improving your fertility through lifestyle choices.
There are a wide range of tests used to investigate infertility. The first step is usually to have a fertility assessment, which includes:
Assessing your egg count (ovarian reserve) with an antral follicle count (AFC) test and anti-Mullerian hormone (AMH) blood test
or
A sperm assessment, looking at the amount, shape, size and mobility of your sperm cells
If your consultant is concerned about possible conditions affecting your fertility, they may suggest other tests, like imaging scans to look more closely at the structures in your reproductive system.
As many as 1 in 7 couples in the UK struggle with infertility, but there is a wide range of treatments to help. Learn more about the fertility options we offer at TFP Fertility, and how we can support you in creating your family.
If you recognise any of the signs of infertility or have other concerns about your fertility, our fertility experts are here to help. Whether you want more advice, to book an appointment or fertility assessment, reach out through our contact form and our friendly team will be in touch soon.
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