Fertility 101 - The Fertility Journey

Published: 15/09/2022

An overview of the fertility cycle, timeline, IVF practicalities, and the overall fertility process.

Everyone’s fertility journey is unique, so please try not to compare yours with someone else’s, even your sister’s. This is something important to keep in mind because everybody’s journey is different, and can begin at any point in life. In this article we’ll explore what we mean by the fertility journey, as well as share timelines and practicalities of reaching out for fertility support.


What is Infertility?

Infertility Is defined by NICE (2018) Guidelines as a failure to conceive after one to two years of unprotected sexual intercourse. This definition is further broken down into two categories: primary infertility, and secondary infertility. 

  • Primary infertility is for couples who have never conceived even in a previous relationship. 
  • Secondary infertility is for couples who have previously conceived. 

The Fertility Journey

How long your fertility journey will take no one can tell, but there are two ways to start down the path: through the NHS or through a private clinic. The difference being whether your treatment and investigations are self-funded or paid for.

Fertility and the NHS

Through the NHS, your GP is your first point of contact. But, you will have to wait the requisite 1-2 years of trying to conceive before being sent for fertility investigations or have a referral to a fertility clinic. And depending where you live, unfortunately you're not always guaranteed free fertility treatment. It can be a postcode lottery with different boroughs funding fertility treatment, where others don’t. 

However, if you choose to self-fund your fertility journey you do not need to wait before reaching out for fertility support. 

Private fertility clinics

If you choose to go down this route, the first step is choosing which fertility clinic to go with. And often with a private fertility clinic, the process moves as quickly as you want it to as you are paying for it.

The common process for fertility treatment includes: 

  • Initial consultation 
  • Investigations 
  • Follow up consultation 
  • Decide on treatment plan 
  • Start cycle

Initial investigations for a woman may include: 

  • Blood tests (AMH, FSH, LH, PROG,) 
  • Transvaginal/abdominal scans 
  •  Hycosy/ HSG 
  • STI check

Further investigations during treatment may include: 

  • Rubella Immunity status 
  • Thyroid function test 
  • Full blood count 
  • Virology ( HIV, HEP B, HEP C)

For men the tests might include: 

  • Semen analysis 
  • STI check

Exploring fertility treatment

The fertility treatment suggested by your consultant or doctor will be dependent on the outcome of investigations, the different levels of treatment options, and they’re invasiveness. Which route you go down will be a shared decision between you as a couple and the clinician. 

Bear in mind that fertility treatment can be intense, with multiple visits to the clinic during a treatment cycle. These visits tend to be in the morning and can be as frequent as every other day. 

This is something to take into serious consideration when considering going down the fertility path as appointments need to be weaved around the hustle and bustle of daily life, including work, school drops, commutes etc.

What is a treatment cycle?

Most treatment cycles start on day one of your menstrual cycle. In a regular natural cycle, you will have a bleed on day one (your period). Your body will then start to grow a follicle. 11-16 days later you will ovulate. Two weeks post ovulation, if you’re not pregnant, you will have another bleed. 

Fertility treatments

In fertility treatment, scans, medications, and instructions are given during your cycle to increase/improve chances of conception or to preserve your eggs. These scans, medications, and instructions take place within the treatment cycle agreed upon with your clinician. 

Treatments can include Ovulation Induction, Intrauterine Insemination, In Vitro fertilisation, or Egg Freezing.

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