Female Infertility

Trying for a baby and nothing’s happening? Most couples conceive within a year, but about 1 in 6 need help. Age matters most, so if you’re 35 or older, see your GP after 6 months, not 12.

When to see your GP

• After 12 months of trying, or 6 months if you’re 35 or older
• Straight away with irregular or absent periods, known endometriosis or PCOS, past pelvic infection, or a partner with a known sperm problem
• Planning ahead? A pre-pregnancy check (folic acid, vaccines, health conditions) is worth it anyway

Common causes

• Age: egg number and quality fall, especially after 35 and faster after 40
• Ovulation problems: PCOS is the most common; also thyroid, high prolactin, very low weight or intense exercise
• Endometriosis
• Blocked tubes: past chlamydia or pelvic infection, or surgery
• Uterine problems: some fibroids or polyps
• Male factor in about half of couples: the semen test is part of your workup
• Unexplained in about 1 in 4 couples

Tests

• Progesterone 7 days before an expected period to check ovulation, plus thyroid, prolactin and other hormones
• Pelvic ultrasound, and a dye test of the tubes (HyCoSy or HSG)
• Chlamydia test, and a semen analysis for your partner
• AMH estimates egg number, not quality or your chance of natural pregnancy

What helps

Treatment depends on the cause and your age.

1. Step 1 · Self-careFolic acid, a healthy weight, no smoking, less alcohol, sex every 2–3 daysRegular sex through the cycle works as well as timing it exactly.

   Works

   Weight loss restores ovulation in many with PCOS

   Cost

   Low cost

   How long

   Ongoing

   Watch for

   Tracking every hormone and temperature can turn sex into a job. Every 2–3 days covers the window.

2. Step 2 · GP and specialistLetrozole to trigger ovulation, e.g. in PCOSA tablet for 5 days early in the cycle.

   Works

   More live births than clomiphene in women with PCOS in a large trial

   Cost

   Low cost script

   How long

   Up to about 6 cycles

   Watch for

   Twins are a little more likely.

3. Step 3 · SpecialistSurgery for endometriosis, polyps, some fibroids or blocked tubesSelected cases.

   Works

   Can improve natural pregnancy chances in the right situation

   Cost

   Medicare rebate; private gap

   How long

   One-off

   Watch for

4. Step 4 · Fertility clinicIUI or IVFIVF is the main treatment for blocked tubes, severe male factor, older age and unexplained infertility.

   Works

   Success depends mostly on age: much higher under 35 than over 40

   Cost

   Thousands per cycle after Medicare; lower-cost and public options exist in some states

   How long

   Cycles

   Watch for

Costs are rough Australian prices and vary by pharmacy and provider. PBS co-payment: $25, or $7.70 with a concession card. Results are typical figures from trials, not promises.

Save your money

Popular, heavily marketed or often asked about, but the evidence is weak or says no.

• AMH as a “fertility test”It estimates egg number, not your chance of natural pregnancy. A low AMH doesn’t mean you can’t conceive naturally.
• Endometrial scratchingA large randomised trial found no increase in live births.
• Most IVF add-onsEmbryo glue, assisted hatching and immune therapies mostly lack good evidence. Ask what each adds and the proof.
• Fertility cleanses and detox teasNo evidence, and some contain laxatives or herbs that are unsafe in early pregnancy.

Helpful resources

• Your FertilityAustralian Government-funded fertility information. Free.
• Jean Hailes for Women’s HealthWomen’s health information. Free.

Evidence and more information

• Legro RS et al. Letrozole versus clomiphene for infertility in PCOS (NEJM 2014)
• Lensen S et al. A randomized trial of endometrial scratching before IVF (NEJM 2019)

Updated 14 November 2026. General education, not personal medical advice. Treatment depends on your situation, so talk to your GP or pharmacist.

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