Fertility Difficulties (Trouble Conceiving)
Trying for a baby and it isn't happening yet? You're not alone, and trouble conceiving is rarely about one person or one thing. Most causes are treatable, and knowing when to seek help — and what an evaluation involves — takes a lot of the worry out of it.
General education, not a diagnosis. SHELY is pre-launch — “Talk to someone” adds you to our experts waitlist; we don’t offer bookings yet.
Difficulty conceiving — often called infertility — usually means not becoming pregnant after about a year of regular, unprotected sex (or six months if you're 35 or older). It's far more common than people realise, and it's almost never a sign that something is 'wrong' with you as a person.
Fertility is a shared story. Roughly a third of cases trace back to a female factor, a third to a male factor, and the rest to a combination of both or no clear cause at all. In women, the most common culprits are ovulation problems (often from PCOS or thyroid imbalance), blocked or damaged fallopian tubes, and endometriosis. Because so many of these are treatable, the most important step is simply getting a proper look at what's going on — for both partners.
Age matters, gently but genuinely. Egg quality and quantity decline over time, especially after the mid-30s, so the timeline for seeking help is shorter as you get older. Acting earlier keeps more options open — and that's the whole point of an evaluation, not to alarm you, but to make a plan.
Signs & symptoms
- Not conceiving after 12 months of regular, unprotected sex (or 6 months if 35 or older)
- Irregular, very long, very short, or absent periods — a sign ovulation may not be happening
- Very painful periods or pain during sex (can point to endometriosis)
- Heavy or unusual bleeding between periods
- Signs of hormonal imbalance — acne, excess hair, or unexplained weight changes
- Known conditions like PCOS, thyroid disorder, or previous pelvic infection
- A history of miscarriage or pelvic surgery
- In a male partner: changes in sexual function or a known low sperm count
What causes it
- Ovulation disorders — frequently driven by PCOS or thyroid imbalance
- Blocked or damaged fallopian tubes — often after past pelvic infection (PID)
- Endometriosis affecting the ovaries, tubes, or uterus
- Age-related decline in egg quality and quantity, especially after the mid-30s
- Uterine factors — fibroids or polyps that interfere with implantation
- Male-factor issues — low sperm count, motility, or quality (around a third of cases)
- Unexplained infertility — when all tests come back normal
- Lifestyle and health factors — smoking, significant weight extremes, and uncontrolled chronic illness
When to seek help
If you're under 35, see a doctor after about 12 months of trying without success. If you're 35 or older, seek help after 6 months, and if you're over 40, it's reasonable to ask for an evaluation right away — time is the most valuable thing here. Don't wait the full timeline if you already have known risk factors such as very irregular or absent periods, PCOS, a thyroid condition, endometriosis, a past pelvic infection, or previous miscarriages. Both partners should be checked together; many causes are quick to identify with a few tests.
How SHELY helps
SHELY Care
Track your cycles and symptoms over time to spot ovulation patterns and bring a clear, useful history to your fertility appointment.
Ovulation Calculator
Estimate your most fertile days each cycle so you can time trying to conceive with confidence.
IVF Due-Date Calculator
If you're on an IVF or embryo-transfer path, work out your estimated due date from your transfer details.
SHELY Varsity
Evidence-based guides on fertility, what a workup involves, and the treatment options from timed cycles to IUI and IVF.
Not sure what comes next?
Pick a topic to explore what we know about Fertility Difficulties (Trouble Conceiving). Educational only — not a diagnosis.
- Not conceiving after 12 months of regular, unprotected sex (or 6 months if 35 or older)
- Irregular, very long, very short, or absent periods — a sign ovulation may not be happening
- Very painful periods or pain during sex (can point to endometriosis)
- Heavy or unusual bleeding between periods
- Signs of hormonal imbalance — acne, excess hair, or unexplained weight changes
- Known conditions like PCOS, thyroid disorder, or previous pelvic infection
- A history of miscarriage or pelvic surgery
- In a male partner: changes in sexual function or a known low sperm count
- Ovulation disorders — frequently driven by PCOS or thyroid imbalance
- Blocked or damaged fallopian tubes — often after past pelvic infection (PID)
- Endometriosis affecting the ovaries, tubes, or uterus
- Age-related decline in egg quality and quantity, especially after the mid-30s
- Uterine factors — fibroids or polyps that interfere with implantation
- Male-factor issues — low sperm count, motility, or quality (around a third of cases)
- Unexplained infertility — when all tests come back normal
- Lifestyle and health factors — smoking, significant weight extremes, and uncontrolled chronic illness
If you're under 35, see a doctor after about 12 months of trying without success. If you're 35 or older, seek help after 6 months, and if you're over 40, it's reasonable to ask for an evaluation right away — time is the most valuable thing here. Don't wait the full timeline if you already have known risk factors such as very irregular or absent periods, PCOS, a thyroid condition, endometriosis, a past pelvic infection, or previous miscarriages. Both partners should be checked together; many causes are quick to identify with a few tests.
SHELY Care
Track your cycles and symptoms over time to spot ovulation patterns and bring a clear, useful history to your fertility appointment.
Ovulation Calculator
Estimate your most fertile days each cycle so you can time trying to conceive with confidence.
IVF Due-Date Calculator
If you're on an IVF or embryo-transfer path, work out your estimated due date from your transfer details.
SHELY Varsity
Evidence-based guides on fertility, what a workup involves, and the treatment options from timed cycles to IUI and IVF.
Symptoms
- Not conceiving after 12 months of regular, unprotected sex (or 6 months if 35 or older)
- Irregular, very long, very short, or absent periods — a sign ovulation may not be happening
- Very painful periods or pain during sex (can point to endometriosis)
- Heavy or unusual bleeding between periods
- Signs of hormonal imbalance — acne, excess hair, or unexplained weight changes
- Known conditions like PCOS, thyroid disorder, or previous pelvic infection
- A history of miscarriage or pelvic surgery
- In a male partner: changes in sexual function or a known low sperm count
Causes
- Ovulation disorders — frequently driven by PCOS or thyroid imbalance
- Blocked or damaged fallopian tubes — often after past pelvic infection (PID)
- Endometriosis affecting the ovaries, tubes, or uterus
- Age-related decline in egg quality and quantity, especially after the mid-30s
- Uterine factors — fibroids or polyps that interfere with implantation
- Male-factor issues — low sperm count, motility, or quality (around a third of cases)
- Unexplained infertility — when all tests come back normal
- Lifestyle and health factors — smoking, significant weight extremes, and uncontrolled chronic illness
When to seek care
If you're under 35, see a doctor after about 12 months of trying without success. If you're 35 or older, seek help after 6 months, and if you're over 40, it's reasonable to ask for an evaluation right away — time is the most valuable thing here. Don't wait the full timeline if you already have known risk factors such as very irregular or absent periods, PCOS, a thyroid condition, endometriosis, a past pelvic infection, or previous miscarriages. Both partners should be checked together; many causes are quick to identify with a few tests.
How SHELY helps
SHELY Care
Track your cycles and symptoms over time to spot ovulation patterns and bring a clear, useful history to your fertility appointment.
Ovulation Calculator
Estimate your most fertile days each cycle so you can time trying to conceive with confidence.
IVF Due-Date Calculator
If you're on an IVF or embryo-transfer path, work out your estimated due date from your transfer details.
SHELY Varsity
Evidence-based guides on fertility, what a workup involves, and the treatment options from timed cycles to IUI and IVF.
Frequently asked
How long should we try before seeing a doctor?
If you're under 35, give it about a year of regular, unprotected sex before getting checked. If you're 35 or older, see a doctor after six months, and over 40 it's fine to ask for an evaluation straight away. If you already have irregular periods, PCOS, a thyroid issue, or endometriosis, don't wait — get assessed sooner.
Is trouble conceiving usually 'the woman's problem'?
No — and this is one of the most important things to know. About a third of cases involve a male factor, a third a female factor, and the rest a mix or no clear cause. That's why both partners should be evaluated together; testing the man (a simple semen analysis) is quick and is part of any proper workup.
What does a fertility evaluation actually involve?
For most couples it starts simply: a conversation about your history and cycles, blood tests to check ovulation and hormones (including thyroid), an ultrasound of the ovaries and uterus, a test to confirm the fallopian tubes are open, and a semen analysis for the male partner. These few steps explain a large share of cases and point to the right treatment.
Can conditions like PCOS, thyroid problems, or endometriosis be treated to help?
Very often, yes. PCOS-related ovulation problems frequently respond to lifestyle changes and ovulation-inducing medication; thyroid imbalance can be corrected with treatment that often restores normal cycles; and endometriosis can be managed medically or surgically. Treating the underlying condition is frequently what makes conception possible.
✔ Written from established medical guidance — independent clinical review in progress
This guide is for general education and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your health. In an emergency or crisis, see our crisis support resources.