Why Am I Not Getting Pregnant? When to Seek Help from a Specialist
By Dr Greg Jenkins | Sydney-based specialist in Fertility, Obstetrics and Gynaecology
One of the most common, and often emotionally loaded, questions I hear in my practice is: “Why am I not getting pregnant?” It’s a question that comes with worry, frustration and, sometimes, a quiet sense of guilt. If that sounds familiar, you’re not alone, and more importantly, you’re not doing anything wrong.
I regularly see individuals and couples who have been trying for months, sometimes years, wondering if they’ve missed something or if there’s a deeper issue at play. In many cases, they simply haven’t had the opportunity to talk to someone who can guide them through the ‘what now?’
So in this post, I want to walk you through when it might be time to seek help, what signs to look out for, and why a fertility assessment doesn’t mean something’s wrong, it just means you're ready for a clearer path forward.
How Long Should It Take to Fall Pregnant?
Timing is everything, and yet, this is often misunderstood. For healthy couples under the age of 35, about 80% will conceive within 12 months of regular, unprotected sex. But that still means it can take several months, even when everything is functioning as it should.
In general, we say:
If you're under 35 and have been trying for 12 months without success, it's time to check in.
If you're 35 or older, it's wise to seek advice after 6 months of trying.
If you have a known condition like polycystic ovarian syndrome (PCOS), endometriosis, or irregular cycles, it’s worth speaking with a specialist earlier—sometimes even before you start trying.
The idea isn’t to rush into treatment. It’s to understand what’s going on sooner, so you’re not losing precious time if there is a barrier to conception.
When to Consider a Fertility Assessment
There are a few signs I often tell patients to look out for that might suggest it’s time to book an appointment with a fertility specialist:
Irregular or absent periods: This can suggest problems with ovulation.
Painful periods or intercourse: These could point to conditions like endometriosis.
Known reproductive issues: Such as PCOS, fibroids or previous pelvic infections.
Male factor concerns: Low libido, past injuries or even lifestyle factors like smoking or steroid use can impact sperm health.
Past miscarriages: Recurrent pregnancy loss is a reason to dig a little deeper.
General ‘gut feeling’: Sometimes, even if nothing obvious stands out, your instincts might tell you something's not quite right—and that’s valid too.
An early assessment can help clarify what’s working well and what might need support, whether that’s cycle tracking, lifestyle changes or something more involved.
What Happens at Your First Appointment?
Understandably, many people are hesitant to book that first visit. There's a worry it will lead straight into invasive tests or treatments. But more often than not, it starts with a conversation.
In a typical initial consultation, we’ll:
Go through your medical and reproductive history.
Talk about your menstrual cycle and any relevant symptoms.
Discuss your partner’s health and lifestyle (if applicable).
Decide whether any baseline tests, like blood work or an ultrasound, are needed.
It’s all about getting a clearer picture of your fertility health and empowering you with the next steps. For some, that might mean simple reassurance. For others, it might mean identifying and addressing a specific barrier.
Why Sooner is Often Better
Waiting too long to seek help can sometimes mean we miss out on critical windows of time, especially as egg quality and quantity naturally decline with age. I often meet couples who tell me they “just didn’t want to overreact,” only to find that they would’ve benefited from a conversation a year earlier.
Fertility is deeply personal. But you don't need to navigate it in the dark.
The Takeaway: You're Not Failing—You're Ready for Clarity
If you’re struggling to fall pregnant and finding yourself wondering what’s going on, it might be time for answers. That doesn’t mean you’re broken or that something’s wrong, it just means it’s time to get curious, not discouraged.
As a specialist who deals with fertility problems, I see the full spectrum—couples who fall pregnant with minimal help, and those who need a more supported path. Either way, the sooner we can identify what’s happening, the more tailored and effective our approach can be.
If you’re unsure where to start, reach out. A conversation can be the first step toward clarity, and, hopefully, toward the family you’re hoping to grow.
