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How to access care through the NHS

We know it can be upsetting when you’re trying for a baby and you’re not getting pregnant as quickly as you may have hoped. The NHS explains that around 84% of heterosexual couples will conceive within a year if they have regular, unprotected intercourse. This means that some couples may conceive quickly, but for others, it may take longer. Here we’ll explain when you should seek medical advice, what you can expect from your GP and what your next steps may be. 


When should you see a GP about your fertility?

The National Institute for Health and Care Excellence guidelines state you should visit your GP if:

  • You’re under the age of 35 and you’ve been trying to conceive for 1 year
  • You’re over the age of 35. Get in touch with your GP sooner as you may be able to access investigations earlier
  • You or your partner have a condition that is known to affect fertility, as you may be able to access investigations earlier


What will you discuss with your GP?

Your GP will perform an assessment and determine if you’re eligible to access tests in order to see if there are any underlying causes of the fertility problems you may be experiencing. They will ask specific questions relating to your reproductive health and sexual intercourse. This may feel uncomfortable to talk about, but it’s important to be as open as you can, as your GP is there to help you. In order to help you prepare for that visit with your GP, here are some questions you may be asked:

  • Contraception
    If you’ve taken any type of contraception, your GP will want to know what type and when you stopped using it. They may ask if you experienced any side effects while taking/coming off of contraception.
  • Your menstrual period
    You may be asked when your last menstrual period was, how long your menstrual cycles are and if they are regular. This can help determine if there’s any irregularity in your ovulation.
  • Sexual intercourse
    You’re more likely to get pregnant around the time of ovulation, so your GP may ask you questions about when and how frequently you have intercourse.
  • Known medical conditions or medication
    Some long-term medical conditions and some medications can have an impact on your ability to conceive. It’s important to discuss these with your GP to get the best medical advice when moving forward.
  • Lifestyle factors
    Smoking and passive smoking can reduce the chances of getting pregnant. You may be asked about your alcohol consumption, as excessive drinking can have a negative impact on semen quality. You may be asked about your weight or asked to be weighed, as the guidelines recommend having a BMI between 19 and 30.
  • Cervical smear
    Your GP will also make sure that your cervical smear is in date. Cervical screening is a way of checking if there are any abnormal cells in the cervix, which would sometimes need to be removed. This would need to be done before any potential pregnancy.
  • Rubella status
    Your rubella status will also be checked, as you may need to have a vaccination before getting pregnant.    


Once the assessment has been completed, your GP may request investigations to determine if there’s an underlying cause of fertility problems. This will involve blood tests, an ultrasound and a semen analysis. For more information, read our article Common fertility tests.


Treatment availability on the NHS

Once your GP has completed your fertility investigations, they will decide if you need medical support when trying to conceive and if you are eligible for treatment funded by the NHS. You could be eligible for six cycles of IUI (intrauterine insemination) or three cycles of IVF (in vitro fertilisation) funded by the NHS. However, the provision of funded treatment is determined by your local area, so it’s important that your GP prepares you for what is available to you.


Eligibility

In order to be referred for treatment, you may have to fulfil certain criteria, which may include limitations based on your:

  • Age
  • Body Mass Index (BMI)
  • Length of time trying to conceive
  • Previous children
  • Lifestyle factors
  • Sterilisation

 

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