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Trying for a baby for 12 months - what now?

If you have been trying to get pregnant for 12 months or more, what can you do next, and who should you talk to?

Posted: 3 October 2008
by Laura Lee Davies

When you first start trying for a baby, it can be hard to deal with the disappointment if your period arrives right on time the following month. However, as the months go by, it is easy to start to despair of ever getting pregnant.
Check out the ThinkBaby article How long does it take to conceive? and you will see that the odds are that, as a couple, you are perfectly normal and certainly not alone in needing a few months to get pregnant.
Even if a year has gone by, there is no need to give up hope and there are plenty of options still open to you.

How long should we wait before seeking medical advice or help?
According to the HFEA (the Human Fertilsation and Embryology Authority), most couples who are trying for a baby and having regular sex without any contraception, do not need to seek medical advice until they have been trying for two years.
The stats suggest that 95 per cent of couples (where there are no medical problems, previously detected or otherwise) will successfully conceive within 12 months. However, if you are under 35, they suggest you don't need to seek help until 18-24 months.
If you are over 35, they suggest you try naturally for about six months but then seek some tests. This is only because, if tests suggest you do need assisted conception of any kind, this can require a long wait, and that extra time can affect the quality of your eggs beyond 35 years of age.

What if I'm still not pregnant after 12 months?
Unless there is a reason why your own gynaelogical history might affect successful conception, then the first tests your GP is likely to carry out at this stage, are simple blood tests and possibly a cervical smear test if you have not had one recently.
A blood test taken seven days before your usual menstrual due date will show if you are ovulating normally. A second test during your period will help to show if your hormones are correctly balanced.
You may also be checked to ensure you have been immunised against German measles (rubella) so that you are safe once you are pregnant. You may be tested for chlamydia which is a very common sexually transmitted disease which can go unnoticed for years, but can seriously affect your ability to get pregnant.

What tests will my partner have at this stage?
The first tests a man will have are to check that the sperm is normal, by giving a sample. Plus he will probably have a urine test for chlamydia, too.

Eggs fine, sperm fine - what now?
The HFEA then expect that after problems with the health of egg and sperm production, the following causes are most likely: 16.7 per cent of failures will be due to a problem with the woman's fallopian tubes which carry the fertilised egg to the womb for implantation; 4.9 per cent will be caused by ovulatory problems; 3 per cent will be caused by endometriosis; 0.3 per cent will be affected by issues in the uterus which are hampering successful implantation of the egg; 17 per cent will be a combination of the above; and 18.7 per cent will be because of 'no particular reason'.
At this stage, some doctors may prefer to discuss lifestyle changes and suggest you continue trying through regular unprotected sex. Stress, diet and habits like smoking and drinking can affect your ability to conceive.

Further tests and examination
If you are not pregnant after 12 months of trying, don't worry. You are still a long way off IVF and other treatments at this point. Previous operations, infections or the growth of painless polyps and fibroids can all affect the workings of your reproductive organs and many can be dealt with quite simply.
The following checks can be made:
An ultrasound check at hospital can look in more detail at your ovaries and womb. Sometimes a specialist may want to take a sample of the tissue lining your womb. A different series of ultrasound scans can track the development of your eggs.
An X-ray can check that your fallopian tubes are clear of any blockages, and a Laparoscopy (sending a tiny camera on a tube through your cervix) can check for other tube blockages. Otherwise, a vaginal ultrasound may do a similar check.
A Hysteroscopy will look for fibroids and polyps.
You will probably not need to have lots of these tests but specific ones depending on discussions with your GP and any specialist you have been referred to at the hospital or clinic.

What then?
If you get advice that you may need some form of assisted conception, there are many options you can try. Beyond hormone stimulation and egg production stimulation, there are many different routes to successful conception.For more about the options, check out the ThinkBaby article on assisted conception.
The HFEA website has some great advice for couples who are trying for a baby, including information on how to go about deciding what to do next, and what clinics are available to you.

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Discuss this story

Hi all

Been ttc now for 13month. Went to doctors on 11 month and was told I needed blood tests taken on day 1 and day 21 of next cycle. Got second test results today and all came back normal, OH has also been for sperm test which also was OK.

Have made an appointment at the doctors for Friday to find out what happens next.

Does anyone know what I should expect? Is anyone else going through the same? Guess that maybe the next step is to be referred to a consultant, anyone any ideas on waiting times?

Heard about Clomid, but will they prescibe that if I have very regular periods and (according to the blood tests) Ovulate ok?

Thanks for any information

Posted: 30/10/2006 at 09:21

Hi Louise
Thanks for your message.
Sorry to hear that you still haven't had any luck, especially as everything seems to be OK.
I think you raise a really interesting question and I will look into this today to get an article written this week on the site.
In the meantime I will flag up your question as I think there are probably other expectant mums on the site who have been through the same experience as you.
I would suspect that clomid is not neccessarily an option if you are ovulating regularly, and that it may well be a more internal examination to see if there is somethign happening to prevent successful implantation.
Will come back to you on this.
Best Laura (editor)

Posted: 30/10/2006 at 11:42

Hi Laura

Thanks for your help


Posted: 30/10/2006 at 11:49

Hi Louise
How are you doing? I have attached a new article on the next step in tests etc, above. I hope it helps.

Posted: 01/11/2006 at 12:23

Thanks Laura, that is a very informative and useful article.
I too have been wondering what will happen if I don't conceive soon, as I have not being using contraception for 2 years and am still not pregnant. My doctor told me not to worry until I had been 'actively trying' for 12 months, as although I hadn't been using contraception I wasn't actively trying to conceive until recently. Now I know there is alot that can be investigated and done if I don't get my BFP over the next 10 months. Thanks again.

Posted: 01/11/2006 at 16:57

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