How long does it normally take?

Longer than most people expect, and the spread is wide. That is exactly why the thresholds exist — one year, or six months over thirty-five — because they give you something other than your own worry to measure against. Being inside that window is not a sign anything is wrong.

Should my partner get tested too, or should I go first?

Together, and from the beginning. NICHD is explicit that problems in the male are just as likely as in the female, and a semen analysis is one of the simplest tests in the whole process. Doing it early can save months of investigating the wrong half.

Is stress causing this?

It is the most common thing people are told and the least useful. This stage is genuinely stressful, and treating the stress as the cause tends to add guilt to a situation that already has plenty. Look after yourself because this is hard, not as a fertility treatment.

Does an evaluation mean we're heading for IVF?

No. An evaluation is a set of questions and tests to find out what is going on, and a great many people who have one never need anything close to IVF. It is information-gathering, and having information earlier tends to widen the options rather than narrow them.

Before it starts · 4 min read

Trying, and it hasn't happened yet

Every month has a shape to it now, and the shape is not a good one.

This page exists because everything else here starts at a positive test, and a lot of people spend a long, quiet, unsupported stretch before that.

Last updated August 20, 2026

The line, so you are not guessing

NICHD's definition is specific: infertility describes a couple unable to achieve pregnancy after one year of regular, unprotected sex — or after six months if the woman is older than thirty-five.

That is not a diagnosis and it does not mean it will not happen. It is the point at which asking someone to look is a normal, proportionate step rather than an overreaction, which is the reassurance most people are actually waiting for.

If there is already a reason to look sooner — periods that are irregular or absent, a history of pelvic infection or surgery, or something already known about either partner — that conversation does not need to wait out the clock.

Both halves of the picture

NICHD puts it plainly: problems in the male are just as likely as problems in the female.

That sentence is worth repeating because of what happens in practice. The investigation very often begins and sometimes ends with the woman, who undergoes the more invasive and more numerous tests, while a semen analysis — which is quick, simple and non-invasive — gets deferred.

If you take one practical thing from this page, it is to ask for both partners to be assessed from the start. It is faster, it is kinder, and it means you are not several months into investigating one person while the answer sits unexamined.

NICHD also notes that in many cases the exact cause remains unknown — idiopathic infertility. That is a real and common outcome, and it is not the same as nothing being wrong or nothing being treatable.

The part that is not medical

This stage is isolating in a specific way. It is usually private, it repeats on a monthly cycle, and the people around you are often announcing exactly the thing you are waiting for.

It also tends to arrive with a lot of self-blame, and most of it is misdirected — at a body that is not cooperating, at a decision to wait, at stress itself. Being told to relax is close to universal and close to useless.

If you are finding it hard in a way that is affecting your sleep, your work or your relationship, that is worth saying out loud to someone, and it is a legitimate reason to seek support in its own right rather than something to earn by first exhausting the medical route.

Worth raising sooner rather than later

Periods that are irregular, very heavy, very painful, or absent.

Any previous pelvic infection, pelvic surgery, or known endometriosis.

A known issue affecting either partner, including previous cancer treatment.

Two or more miscarriages.

Being over forty and trying — that is a conversation to start now rather than after a waiting period.

Common questions

How long does it normally take?: Longer than most people expect, and the spread is wide. That is exactly why the thresholds exist — one year, or six months over thirty-five — because they give you something other than your own worry to measure against. Being inside that window is not a sign anything is wrong.
Should my partner get tested too, or should I go first?: Together, and from the beginning. NICHD is explicit that problems in the male are just as likely as in the female, and a semen analysis is one of the simplest tests in the whole process. Doing it early can save months of investigating the wrong half.
Is stress causing this?: It is the most common thing people are told and the least useful. This stage is genuinely stressful, and treating the stress as the cause tends to add guilt to a situation that already has plenty. Look after yourself because this is hard, not as a fertility treatment.
Does an evaluation mean we're heading for IVF?: No. An evaluation is a set of questions and tests to find out what is going on, and a great many people who have one never need anything close to IVF. It is information-gathering, and having information earlier tends to widen the options rather than narrow them.

If it's this, not that

Still not sure

This page is the general answer. Yours is a specific child.

The advisor can be. It has read everything here, and it knows how old your children actually are — which is the whole difference wherever guidance changes with age. Ask it anything.

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It answers from the same cited pages you are reading, and when the question is where to go, from the real clinician, hospital and childcare records behind this site — not a link to go search them yourself. It says so when we have not written about something, and it is not a doctor; for anything urgent it gives you the threshold and tells you to call.

Where this comes from

Every claim on this page traces to one of these. See every source we use →

Written from the sources named above, and it is not a substitute for your own doctor. If something feels wrong to you, that instinct is a good enough reason to call — you know yourself and this family better than any page does.