Infertility
Investigate both partners after 12 months (6 months if the woman is 35 or older), confirm ovulation, check tubes and semen, sort anovulation by the WHO groups, and never give testosterone to a man who wants children.
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Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Infertility is failure to conceive after 12 months of regular unprotected intercourse. NICE (updated 2026) keeps this definition. About 1 in 6 couples are affected.
- Investigate both partners together. Start at 6 months if the woman is 35 or older (Australian and ASRM practice; NICE, in CG156 and again in NG257, uses 36 or older for earlier referral), and straight away if there's an obvious cause.
- Female age is the strongest single predictor. Fecundity falls steadily after the early 30s and sharply after 37.
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Sources
- Fertility problems: assessment and treatment (NG257), replacing CG156National Institute for Health and Care Excellence, 31 March 2026
- Fertility problems: assessment and treatment (CG156)National Institute for Health and Care Excellence, 2013, superseded
- ESHRE guideline: unexplained infertilityEuropean Society of Human Reproduction and Embryology, 2023
- WHO laboratory manual for the examination and processing of human semen, 6th editionWorld Health Organization, 2021
- Steiner AZ et al. Association between biomarkers of ovarian reserve and infertility among older women of reproductive age. JAMA 2017;318:1367-76JAMA, 2017
- Your Fertility (fertility information for health professionals)AU/NZVictorian Assisted Reproductive Treatment Authority and Healthy Male
- Male infertilityAU/NZHealthy Male (Andrology Australia)
- Endocrinology (Therapeutic Guidelines)AU/NZTherapeutic Guidelines Ltd
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Deploy to Cloudflare on push to main