Why can't we get pregnant?

Infertility is usually defined as ‘not being able to conceive after 12 months of regular sexual intercourse without contraception’. Approximately 1 in 7 couples (15%) will experience infertility.

Many complex processes in the body have to be in perfect alignment to achieve a pregnancy. It is often presumed that infertility is a ‘female’ problem. However, infertility is equally due to both male and female problems.

Causes of infertility

Female Infertility

  • Ovulation disorders (e.g. Polycystic Ovarian Syndrome)
  • Fallopian tube problems
  • Endometriosis
  • Poor egg quality/older age

Male Infertility

  • Obstruction (blocked/absent Vas)
  • Disorders of sperm production (not making enough good quality sperm)
  • Psychosexual problems (erection and ejaculation problems)


  • This is when all the initial tests are normal. However, there may still be an underlying problem, such as fertilisation or implantation failure

When should I seek medical advice?

  • After 12 months of infertility
  • Sooner, if > 35 years old
  • If either partner has a pre-existing condition known to be associated with infertility

If you are a woman over 35 years old, it is recommended you seek medical advice if you are not pregnant after 6 months of trying. This is because a woman’s fertility rate starts to decline rapidly from this age.

What should I expect at my first medical appointment?

Initially, I will take a full medical and sexual history, which may identify an obvious problem, such as ‘timing’ of sexual intercourse or ‘irregular’ ovulation in the woman.

Lifestyle Factors

You will also be asked about lifestyle factors, such as smoking, stress, alcohol consumption, diet, exercise and weight, which can also affect your fertility. To understand how lifestyle factors can affect both male and female fertility see the Your fertility website.


Some or all of the following investigations may be ordered:

For females:

  • Hormone blood tests – to confirm ovulation
  • Infection screening blood tests – to check immunity to certain infections that may impact on a pregnancy, e.g. rubella, chicken pox, hepatitis B &C, HIV, syphilis, chlamydia
  • AMH – Anti-Mullerian Homone or ‘Egg Timer Test’ (see Preserving my fertility for more information)
  • Pelvic ultrasound
  • Tubal patency test or laparoscopy

For males:

  • Semen analysis

At your next appointment, your results will be reviewed to decide if any further investigations are needed or what treatment is required. If investigations have already been done, it is a good idea to bring along any blood test, ultrasound or semen analysis results to your appointment.

Contact Dr Nicole Hope
IVF & Fertility Care, Melbourne

8 am–5 pm

except public holidays

03 9890 1811
Dr Nicole Hope consults at
the following locations:
Box Hill
Suite 17
28–32 Arnold Street
View map
Latrobe Medical Centre
920 Plenty Rd
View map
Newlife IVF
245 Clayton Road
View map

Hope starts here.
Send a confidential message to Dr Nicole Hope: