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If you and your partner haven't been able to have a baby, the first step in getting help is to see your doctor. It helps if you go together.

Your doctor will want to ask you both some questions (this is called taking a history), do a physical exam, carry out some tests and give you some advice.

You'll probably both be asked about:

• How long you've been trying to get pregnant. Most doctors agree that you have fertility problems if you've been trying for a baby for at least one year.¹
• How often you have sex and if there are any difficulties with sex. To get pregnant you should have sex every two to three days, every week, rather than trying to have sex around the time the woman ovulates.

If you're a woman, you'll probably be asked about:

• Your periods and whether they are regular
• Contraception: What you used and how long ago you stopped using it
• Previous pregnancies (if you have had any) and whether there were problems
• Sexually transmitted diseases such as chlamydia or gonorrhea
• Any other diseases or illnesses you might have had
• Surgery in your pelvic area
• What medicines you are taking (some drug treatments can affect your fertility)
• Your lifestyle: You may be asked whether you smoke, whether and how much you drink or take drugs, whether you travel in your job (this can restrict the chances of sex with your partner), whether you are under stress.

If you're a man, you may be asked about:

• Whether you have any children (with the same partner or different partners)
• Whether you have ever had mumps (this can affect your fertility if you are a man)
• If you have had any sexually transmitted diseases such as chlamydia or gonorrhea
• Whether you have had problems with your testicles, with having sex, getting an erection or having a climax (ejaculating)
• Any diseases or illnesses you might have had
• What medicines you are taking, if any (some drug treatments can affect your fertility)
• Your lifestyle: Whether you smoke, drink, travel a lot (this can restrict the chance of having sex with your partner), take drugs, or are under stress, and so on.

Your doctor will probably give you both a general exam that includes measuring your height, weight and blood pressure. He or she may take some routine blood tests.

Your doctor will also arrange for you to have some tests to check:

• Whether you're ovulating regularly if you're a woman
• What your sperm look like and how many there are of them if you're a man.

For more about these tests, see Fertility tests: the first round.

If these first tests show that the woman is ovulating normally and her partner's sperm is normal, the woman is likely to be advised to have further tests.

Your doctor will also give you some general advice about getting pregnant. You may be advised, for example, to stop smoking, cut down on alcohol, eat a healthy diet or lose weight if you are very overweight (obese). You may also be told about the kind of investigations and treatments for infertility that you could have.

Your doctor will usually refer you to a specialist if you have been trying to have a baby for one year. You are more likely to be referred after six months if:¹

• The woman is aged over 35 years or has irregular or no periods
• The physical examination is abnormal for either partner
• Either of you has ever had a sexually transmitted disease or an operation on your abdomen
• You've had a history of infertility before.

Your doctor may refer you to an infertility specialist. Later you may be referred to a doctor who does IVF (in vitro fertilization). You may choose an IVF center after looking at its success rates.² IVF is expensive, and you may or may not have insurance coverage. Different centers may charge different amounts of money.

When you see a specialist at a fertility clinic, he or she will examine you. You may also be advised to have further tests to find out more about your infertility. See Further fertility tests.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.