Trying for a Baby? When a Couple Should See a Fertility Doctor

How Long Does It Normally Take?

Getting pregnant often takes longer than couples expect. Among healthy couples having regular unprotected sex, most conceive within the first year, and many take several months. Not getting pregnant in the first few months is normal and is not a reason to panic.

Doctors define infertility as not getting pregnant after 12 months of regular unprotected sex. It affects roughly 1 in 6 people at some point in their lives, and it is a medical condition like any other, with causes that can often be found and treated.

When You Should Book a Visit

• After 12 months of trying, if the woman is under 35
• After 6 months of trying, if the woman is 35 or older
• Straight away if the woman is over 40
• Straight away if periods are very irregular or absent
• Straight away if either partner has had a sexually transmitted infection, pelvic infection, or surgery on the reproductive organs
• Straight away if the woman has known endometriosis or fibroids, or has had more than one miscarriage
• Straight away if the man has had a testicular injury, surgery, mumps in adulthood, or problems with erection or ejaculation

Both Partners Need to Be Tested

In many families, a woman is blamed when a couple has no children. Medically, this is wrong. A male factor contributes to about half of all cases of infertility, and in some couples both partners have a problem.

Testing the man is also the simplest and cheapest place to start. A semen analysis is quick and painless, and it can save the woman months of unnecessary tests. The most useful first visit is one the couple attends together.

Common Causes in Women

• Ovulation problems, often caused by polycystic ovary syndrome (PCOS), thyroid disease, or being very underweight or overweight
• Blocked fallopian tubes, most often from past sexually transmitted infections, pelvic infections or complications after childbirth or an unsafe abortion
• Fibroids, endometriosis or other conditions of the womb
• Age: fertility declines gradually from the early 30s and more quickly after 35

Common Causes in Men

• Low sperm count, or sperm that do not move or shape normally
• Past infections, including sexually transmitted infections and mumps
• Varicocele: swollen veins in the scrotum that overheat the testicles
• Smoking, heavy drinking, obesity and some medicines
• Heat exposure, for example from hot baths or keeping a laptop on the lap for long periods

What Tests to Expect

• For both: a medical history, examination, and screening for sexually transmitted infections
• For the man: a semen analysis, and sometimes hormone tests or a scrotal ultrasound
• For the woman: blood tests to confirm ovulation and check hormones, a pelvic ultrasound, and a test to check whether the fallopian tubes are open

Improving Your Chances Naturally

• Have sex every two to three days throughout the cycle. This covers the fertile window without the stress of timing it exactly.
• The most fertile days are the five days before ovulation and the day of ovulation itself. Our menstrual cycle guide explains how to spot them.
• Women should start folic acid before conceiving to protect the baby's development.
• Both partners should aim for a healthy weight, stop smoking, and cut down on alcohol.
• Get tested and treated for sexually transmitted infections, which are a leading preventable cause of infertility.

Myths and Facts

• Myth: Infertility is always the woman's problem. Fact: Men contribute to about half of all cases.
• Myth: Using contraception in the past causes infertility. Fact: Fertility returns after stopping the pill, implant or IUD. The injectable can delay return by several months, but it does not cause permanent infertility.
• Myth: Lying with your legs raised after sex helps you conceive. Fact: Sperm reach the womb within minutes. Position makes no proven difference.
• Myth: If a man can have sex, he must be fertile. Fact: Sexual function and sperm quality are separate. Only a semen analysis can tell.
• Myth: Infertility is caused by a curse or punishment. Fact: It has medical causes, many of which can be treated.

Treatment Options

Treatment depends on the cause. Many couples need only simple steps, such as medicine to trigger ovulation, treatment of an infection, or surgery for fibroids or blocked tubes. Others benefit from assisted reproduction such as IUI or IVF. Rwanda's 2025 health law now also regulates assisted reproductive technologies, giving couples clearer options within the country.

Fertility Care at ClinicRW

Our Obstetrics & Gynecology team offers private fertility consultations for couples. We start with the right tests for both partners, explain the results clearly, and guide you to the most suitable treatment. Trying for a baby can be emotionally hard, and our team is here to support you, not to judge.