Fertility concerns affect millions of women worldwide and are becoming increasingly common. According to global health data, more than 100 million women were affected by infertility in 2021, with prevalence steadily rising over recent decades. While this increase reflects changing lifestyles, delayed childbearing, and improved diagnosis, it does not mean that fertility problems are inevitable — or untreatable.

For many women, difficulty conceiving is linked to underlying gynaecological or hormonal conditions that can be diagnosed and managed effectively. Importantly, experiencing fertility challenges does not automatically mean that you will require IVF or advanced fertility treatment. In many cases, early evaluation by a consultant gynaecologist can identify manageable causes and support natural conception.

Understanding when to see a gynaecologist for fertility problems — and why a gynaecologist is often the first specialist to consult — can make a significant difference in both outcomes and peace of mind.

Why Fertility Problems Are Increasing

Several factors contribute to the rising number of women experiencing fertility concerns:

• Delayed childbearing due to career or lifestyle choices
• Increased prevalence of conditions such as PCOS and endometriosis
• Higher rates of obesity and metabolic disorders
• Greater awareness and improved diagnosis
• Environmental and lifestyle influences

However, statistics reflect population trends, not individual destiny. Many women with fertility concerns go on to conceive naturally once underlying issues are treated appropriately.

When Should You See a Gynaecologist for Fertility Concerns?

General medical guidance recommends:

• Women under 35: Seek advice after 12 months of trying to conceive
• Women aged 35 and over: Seek advice after 6 months
• Women over 40: Consider earlier assessment

That said, these timeframes are not strict rules. If you have known health concerns, irregular periods, pelvic pain, or simply feel anxious about your fertility, there is no reason to delay consultation.

Early evaluation provides:

• Faster diagnosis
• Reassurance
• Reduced stress
• More treatment options
• Better outcomes, particularly where age is a factor

A gynaecologist can begin investigations immediately, avoiding delays that sometimes occur within referral pathways.

Why See a Gynaecologist Before a Fertility Specialist?

It is common to assume that a fertility clinic should be the first step. However, in many cases, a gynaecologist is better placed to begin assessment.

1. Many Fertility Problems Are Gynaecological

Conditions such as PCOS, fibroids, endometriosis, or hormonal imbalances are routinely managed by gynaecologists. Treating these conditions may restore fertility without assisted reproduction.

2. Early Investigations Can Save Time

A gynaecologist can arrange:

• Hormone blood tests
• Ovarian reserve testing
• Pelvic ultrasound
• Transvaginal ultrasound
• Hysteroscopy
• Tubal patency testing

If referral to a fertility specialist becomes necessary, having these results already available streamlines the process.

3. Age Matters

Fertility declines naturally with age, particularly after 35. Waiting several months for specialist referral can feel significant. Direct consultation with a gynaecologist allows earlier action.

Symptoms That Warrant a Gynaecology Appointment

You may benefit from early assessment if you experience:

• Abnormal uterine bleeding
• Very heavy or absent periods
• Irregular menstrual cycles
• Severe period pain
• Chronic pelvic pain
• Previous ectopic pregnancy
• Recurrent miscarriage
• Known PCOS or endometriosis
• History of pelvic infection or sexually transmitted infections
• Previous pelvic or abdominal surgery

Even without symptoms, reassurance and proactive evaluation can be valuable.

Common Causes of Female Fertility Problems

Female fertility depends on several complex processes: ovulation, healthy fallopian tubes, a receptive uterus, and balanced hormones. Disruption in any of these areas may affect conception.

Ovulation Disorders

Ovulation problems account for approximately one quarter of infertility cases.

Conditions include:

• Polycystic Ovary Syndrome (PCOS)
• Thyroid dysfunction
• Elevated prolactin levels
• Premature ovarian insufficiency
• Hypothalamic dysfunction

Irregular or absent ovulation prevents egg release, making conception difficult. The good news is that many ovulation disorders respond well to treatment.

Tubal Damage or Blockage

The fallopian tubes allow sperm and egg to meet. Damage may result from:

• Pelvic inflammatory disease
• Untreated STIs
• Endometriosis
• Previous abdominal surgery
• Ectopic pregnancy

Investigations such as hysterosalpingography (HSG) or ultrasound-based tests can assess tubal patency.

Uterine Abnormalities

Structural conditions can interfere with implantation or increase miscarriage risk:

• Fibroids
• Endometrial polyps
• Uterine septum
• Intrauterine adhesions (Asherman’s syndrome)

Many of these issues can be corrected surgically via minimally invasive procedures.

Endometriosis

Endometriosis affects up to 1 in 10 women of reproductive age. It may impair fertility through:

• Inflammation
• Scar tissue formation
• Adhesions
• Ovarian cysts (endometriomas)

Early diagnosis improves long-term outcomes. Management may involve medication, surgery, or tailored fertility planning.

Premature Ovarian Insufficiency (POI)

When ovarian function declines before age 40, egg reserve decreases significantly. While this diagnosis can be emotionally challenging, early detection allows exploration of options with specialist guidance.

What Happens During a Fertility Assessment?

Consultation with a gynaecologist typically involves:

Detailed Medical History

• Menstrual patterns
• Past pregnancies or miscarriages
• Medical conditions
• Medications
• Surgical history
• Lifestyle factors

Physical and Pelvic Examination

Blood Tests

• FSH and LH
• AMH (Anti-Müllerian Hormone)
• Thyroid function
• Prolactin
• Progesterone (to confirm ovulation)

Imaging

• Transvaginal ultrasound
• 3D pelvic imaging
• Hysteroscopy if required

Partner Assessment

Male factor infertility contributes to nearly 40–50% of cases. Semen analysis may be recommended.

Emotional Impact of Fertility Difficulties

Fertility challenges can be emotionally demanding. Feelings of anxiety, frustration, isolation, and self-doubt are common.

Seeking early medical guidance provides:

• Clear answers
• Structured planning
• Emotional reassurance
• Reduced uncertainty

Many women find that simply understanding the cause of difficulty alleviates significant stress.

Lifestyle Factors That Influence Fertility

While not all fertility problems are preventable, certain lifestyle factors can influence reproductive health:

• Maintaining a healthy weight
• Balanced nutrition
• Regular moderate exercise
• Limiting alcohol
• Avoiding smoking
• Managing stress
• Treating underlying medical conditions

A gynaecologist can provide personalised guidance based on individual health history.

When Fertility Treatment Is Needed

If investigations suggest that assisted reproductive techniques are appropriate, your gynaecologist can coordinate referral to a fertility specialist.

Possible treatments may include:

• Ovulation induction medication
• Intrauterine insemination (IUI)
• In vitro fertilisation (IVF)

Importantly, many women do not require advanced fertility treatment once underlying issues are addressed.

The Importance of Early Action

Fertility outcomes are closely linked to age and overall reproductive health. Early evaluation allows:

• Prompt treatment
• Broader options
• Better planning
• Reduced emotional strain

Even if advanced treatment is ultimately required, starting with a gynaecologist ensures comprehensive assessment and appropriate referral.

What To Do If You Are Struggling to Conceive

If you are concerned about fertility:

1. Track your menstrual cycle.
2. Note any symptoms such as pain or irregular bleeding.
3. Arrange an appointment with a consultant gynaecologist.
4. Attend with your partner where possible.
5. Ask about investigations and timelines clearly.

Taking proactive steps can restore a sense of control and direction.

Final Thoughts

Fertility problems are increasingly common, but they are also frequently manageable. Many causes of infertility fall within the expertise of experienced gynaecologists and can be diagnosed and treated without immediately resorting to complex fertility interventions.

Early consultation provides clarity, reassurance, and a structured plan. Whether treatment involves lifestyle adjustments, medication, minor procedures, or referral to a fertility specialist, understanding your reproductive health is the first and most important step.

If you are experiencing difficulty conceiving — or simply want reassurance — booking a consultation with a specialist gynaecologist can provide both medical insight and peace of mind.