Fertility journey
When getting pregnant takes longer than expected
Let’s say it right away: it’s completely normal if it doesn’t happen right away. Getting pregnant is sometimes an exercise in patience. Most couples don’t conceive within the first month. Only if it takes longer than twelve months (or six months if you’re over 36) do we speak of subfertility — reduced fertility. Until then, give yourself (and your body) time. Fertility isn’t an exact science. Your cycle, your health, and even your lifestyle all play a role.
If you’ve been trying for a while and it still hasn’t happened, you may start to worry. Is this normal? Or is it time to have it checked out? In this article, we’ll calmly walk you through the facts. No panic stories — just clear information on what to expect and when it might be wise to seek help.
What do the numbers say?
Chance of pregnancy when having regular unprotected sex:
- 70% conceive within 6 months
- 80% within 1 year
- 90% within 2 years
Only after one year (or after six months if you’re over 36) do we speak of subfertility — reduced fertility.
Average chance of pregnancy per month, by age:
- Under 30 years: 20%
- 30–35 years: 10%
- Over 35 years: 5%
That means: the older you are, the longer it typically takes. That’s normal — and not a reason to stress right away.
Causes of subfertility or infertility
(source: van Hull, 1985)
- 35%: mild male factor
- 21%: problems with the menstrual cycle
- 14%: blocked or damaged fallopian tubes
- 5%: interaction problems between sperm and cervical mucus
- 5%: severe male infertility
- 20%: unexplained cause
When is it time for a fertility assessment?
A fertility assessment isn’t something you need to rush into. Often, it helps to first look at the basics together with us: what does your cycle look like? When do you have sex? Are there any known medical factors? Testing is only needed when there are signs that something else might be going on.
Your GP will refer you to a gynaecologist if:
- You’re under 36 and have been trying to conceive for 12 months.
- You’re 36 or older and have been trying for 6 months.
Sometimes it makes sense to start testing earlier — for example, if there’s already something known that could affect your fertility.
Possible reasons to seek help earlier
For you (the woman):
- Very irregular cycles (shorter than 21 or longer than 35 days)
- No menstruation at all
- A history of STIs, endometriosis, or treatments that could affect fertility
- Multiple miscarriages
For your partner:
- Known fertility problems (for example, reduced sperm quality)
- Past treatments such as chemotherapy that may affect fertility
For both of you:
- Difficult or painful intercourse (such as vaginismus or erection problems)
What happens during a fertility assessment?
The process usually starts with your GP, who can refer you to a gynaecologist for further testing. This may include:
- Blood tests to check your hormone levels
- An internal ultrasound to examine your uterus and ovaries
- Semen analysis for your partner
The exact steps depend on your situation. Sometimes a few simple tests already provide answers — and sometimes it just takes a bit more time.
Where to find reliable information
A good source is Freya, the Dutch association for people with fertility issues. Their website offers personal stories, information about treatments, and practical tips. Good English associations are: resolve.org, www.cdc.gov-infertility and www.nhs.uk-infertility.