Planning a pregnancy can be exciting and a little stressful at the same time. You may only start thinking about fertility when you begin trying to conceive. About 17 percent of Australian couples experience trouble conceiving, so if it takes longer than expected, you are not alone. Some signs are easy to miss because they feel like everyday period issues. Learning what is typical for your cycle, what might point to a problem, and how testing works in Australia helps you make clear next steps. This guide explains common signs and causes, how doctors assess fertility, what tests involve, and how at home tools like ovulation and pregnancy tests can support timing. It also outlines when to see a GP or specialist, the role of Medicare, and what to expect in public and private care.
Quick Answers About Female Infertility
What is female infertility?
Female infertility means not conceiving after 12 months of regular unprotected sex, or six months if you are over 35. It can also include trouble carrying a pregnancy to birth. A GP can start a basic assessment and refer if needed.
What are early signs to watch for?
Irregular or absent periods, very heavy or painful bleeding, pain during sex, symptoms of thyroid issues, and features of polycystic ovary syndrome can point to a problem. A history of pelvic infections or endometriosis also raises the chance of tubal or pelvic factors.
When should I see a doctor in Australia?
Book a GP visit if you have tried for 12 months without success, or six months if over 35. Seek care sooner for no periods, cycles outside 21 to 35 days, severe period pain, known endometriosis, prior pelvic inflammatory disease, or recurrent miscarriage.
What Is Female Infertility?
Female fertility depends on a sequence of events working in sync. An ovary releases a mature egg. The egg enters the fallopian tube. Sperm travel through the cervix and uterus into the tube to meet the egg and fertilise it. The fertilised egg then moves to the uterus and attaches to the lining, which is called implantation. Problems at any step can make conception harder. Hormones control the release of the egg and prepare the uterine lining. The fallopian tubes need to be open and moving well. The uterus needs a healthy shape and lining for implantation. A partner’s sperm quality also matters, so assessment often includes both partners.
Period patterns are a useful window into this process. Regular cycles often suggest regular ovulation. Irregular, very short, or very long cycles can suggest inconsistent ovulation. Pain that stops you from daily activities, especially with heavy bleeding, can hint at conditions that affect fertility such as endometriosis or fibroids. Pain during sex can be linked to pelvic inflammatory disease or endometriosis and may affect chances of conceiving.
You can read more background on female infertility at Female infertility and common infertility signs. While some period changes are normal, persistent symptoms deserve medical review in Australia.
Common Causes of Infertility in Women
Ovulation disorders are a frequent cause. Polycystic ovary syndrome, often shortened to PCOS, can lead to irregular ovulation. Typical features include irregular cycles, acne, excess hair growth, and signs of insulin resistance such as weight gain around the abdomen. Thyroid problems can also disrupt ovulation. Low thyroid function can delay or prevent egg release. High prolactin can suppress ovulation too. Premature ovarian insufficiency, which means the ovaries stop functioning earlier than expected, is less common but important to diagnose.
Tubal occlusion blocks egg and sperm from meeting. Prior infection with chlamydia or gonorrhoea can cause pelvic inflammatory disease, which may leave scarring in the tubes. Scar tissue, called adhesions, can narrow or block the tube. Early testing and treatment of STIs lowers this risk. Read more about pelvic inflammatory disease at pelvic inflammatory disease.
Endometriosis involves tissue similar to the uterine lining growing outside the uterus. It can change how eggs are released and how sperm and egg meet. It may also affect implantation. Estimates vary, but some studies report that endometriosis is linked with a substantial share of female infertility. Learn more about endometriosis at this endometriosis fact sheet and related research on endometriosis and fertility.
Uterine and cervical causes include fibroids, which are benign muscle growths, and endometrial polyps, which are small growths of the lining. Large fibroids can distort the cavity and affect implantation. Polyps can interfere with the lining. Cervical stenosis, which is a narrowed cervical canal, can reduce sperm passage into the uterus.
Age reduces egg number and quality over time. From the mid thirties onward, conception rates fall and miscarriage risk rises because eggs are more likely to have chromosomal problems. This is a natural change and does not mean pregnancy is impossible, but it does affect timeframes and options.
Hormonal balance and metabolism matter. The thyroid helps regulate metabolism and reproductive hormones. Tests for Thyroid Stimulating Hormone, T3, and T4 can check function. Low thyroid function can be treated with levothyroxine under medical supervision. Many women with PCOS have insulin resistance, where the body needs more insulin to control blood glucose. Signs include abdominal weight gain, strong sugar cravings, and darkened skin patches called acanthosis nigricans. Improving insulin sensitivity through diet changes, regular activity, and medicines such as metformin can support more regular ovulation when prescribed by a doctor.
How Infertility Is Diagnosed in Australia
Start with your GP. A typical first visit covers medical history, periods, past pregnancies, contraception, STIs, pelvic pain, and any chronic conditions. Your GP may suggest tracking periods and ovulation signs for one to two cycles. A physical examination can include checking thyroid size, breast changes, and a pelvic exam if symptoms suggest structural issues.
Initial blood tests often check hormones across the cycle. Common tests include Follicle Stimulating Hormone, Luteinising Hormone, oestradiol, progesterone, prolactin, and Thyroid Stimulating Hormone. Anti Mullerian Hormone can help estimate ovarian reserve. A mid luteal progesterone test about one week before an expected period can show if ovulation likely occurred. Your GP may also order a pelvic ultrasound to assess the ovaries and uterus. A partner’s semen analysis is standard because male factors are present in a large share of couples with infertility.
If tests suggest a condition such as PCOS, endometriosis, or blocked tubes, your GP can refer you to a gynaecologist or fertility specialist. In some cases the tests are normal, which is called unexplained infertility. About one in ten couples worldwide fit this category. Possible reasons include timing issues or egg and sperm not meeting. Read more in this blog here.
What Fertility Tests Involve
Blood tests are straightforward. They involve a standard blood draw and often need timing against your cycle. Day two to five can show baseline hormones. A progesterone test is later in the cycle. Your GP will provide timing instructions so results are meaningful.
Pelvic ultrasound usually uses a transvaginal probe to view the uterus and ovaries in detail. It takes about 15 to 30 minutes. The probe is covered and lubricated. It should not be painful, though mild pressure is possible. The scan can show ovarian follicles, polycystic appearance, fibroids, and endometrial polyps.
Tubal patency is checked with imaging. A HyCoSy uses ultrasound with saline and air to watch bubbles move through the tubes. A hysterosalpingogram uses X ray dye to map tubes and the uterine cavity. Mild cramping is common during these tests. Over the counter pain relief taken beforehand can help if approved by your GP. In some cases, laparoscopy is used to confirm and treat endometriosis or adhesions. A hysteroscopy can remove polyps or small fibroids inside the cavity. Your specialist will discuss risks, benefits, and recovery.
A semen analysis checks sperm count, motility, and shape. It is best done after two to five days of abstinence. If you are concerned about sperm quality, see this overview on sperm health for context and ideas to discuss with your GP.
Managing Fertility at Home and Lifestyle Factors
Cycle tracking helps you identify your most fertile days. Track the first day of bleeding, cycle length, and any symptoms such as mild cramping or spotting. Many Australians use a period app or diary. Aim for sex every two to three days across the cycle or time sex around ovulation if you are comfortable doing so.
Ovulation predictor kits detect the Luteinising Hormone surge in urine that signals ovulation is likely within about 24 to 36 hours. These can be helpful if cycles are regular. In PCOS and some irregular cycles, baseline LH can be higher which can cause false positives. Basal body temperature tracking can confirm that ovulation likely occurred when you see a small sustained rise. It does not predict ahead of time.
Healthy habits support fertility and general health. Maintain a body weight that is healthy for you. Limit alcohol, avoid smoking and vaping, and keep moderate exercise as part of each week. Consider a folic acid and iodine supplement before conception as advised for Australian pre pregnancy care. Manage long term conditions such as thyroid disease or insulin resistance with your GP and take medicines as prescribed. Seek help if stress feels overwhelming. Support from a counsellor or a support group can help during a long trying period.
When to See a GP or Fertility Specialist in Australia
See your GP if you have tried to conceive for 12 months without success. Make it six months if you are over 35. Book sooner if your periods are absent, occur less often than every 35 days, or more often than every 21 days. Seek care for very heavy bleeding, severe pain, pain during sex, prior pelvic inflammatory disease, known endometriosis, or if you have had two or more miscarriages. If you are undergoing gender affirming care or have a condition that affects hormones, ask your GP about tailored preconception advice.
Your GP can start tests, offer lifestyle guidance, and refer you to a gynaecologist or fertility specialist when needed. Referral is common when tests show a structural issue, when ovarian reserve is low, or when age or time trying suggest you would benefit from specialist input. If you prefer, you can ask for a referral to a specific public hospital clinic or a private fertility centre. Your GP can advise on options in your area.
Where Ovulation and Pregnancy Tests Fit In
Ovulation tests help time sex close to when an egg will release. For many, starting tests a few days before the midpoint of the cycle is a good approach. A positive result usually means ovulation will occur within about one to two days. If your cycles vary, begin earlier and test once daily then increase to twice daily as you near your expected fertile window. If you have PCOS, combine test results with other signs such as cervical mucus change and calendar tracking and discuss patterns with your GP.
Pregnancy tests measure human chorionic gonadotropin in urine. The most reliable time to test is from the day your period is due. Testing too early can show a negative even if you are pregnant. A faint line can occur with very early hCG or an evaporation line if read after the time window. Repeat the test after 48 hours or ask your GP for a blood test if you need clarity. No home test can diagnose infertility. They are tools to support timing and early detection. If you are not conceiving, seek medical review even if ovulation and pregnancy tests seem normal.
For more on ovulation timing, see this overview of ovulation, and remember that sperm health, tubal patency, and uterine factors also matter.
Fertility Treatment Pathways in Australia
Australians can pursue care in public hospital clinics or private fertility centres. Public services can offer lower cost care with longer waiting times in some states, particularly in New South Wales and Victoria. Private clinics usually offer faster access and wider scheduling but involve more out of pocket costs. Your GP can help decide which pathway suits your situation and location, including regional centres such as Hobart where choices may be more limited.
Medicare provides rebates for medically indicated investigations and treatments. Rebates apply to parts of assisted reproductive technology such as IVF when criteria are met. Out of pocket costs still apply. You will need a referral from your GP or specialist for rebates. Some private health funds cover day surgery items such as egg pickup. Always ask for an itemised cost plan.
Success rates vary by age, diagnosis, and clinic. A specialist can discuss chances, cycle by cycle expectations, and possible side effects, such as ovarian hyperstimulation, multiple pregnancy risk when more than one embryo is transferred, and the impact of medicines. Many couples conceive with lower intensity options such as ovulation induction or intrauterine insemination before IVF is considered. Setting clear goals and timelines with your clinician can reduce uncertainty.
Frequently Asked Questions About Female Infertility Australia
Do irregular periods always mean infertility?
No. Occasional irregular cycles can happen with stress or illness. Repeated cycles outside 21 to 35 days or months without a period deserve a GP review. Early assessment can reveal a simple cause and guide treatment.
Can endometriosis stop me from getting pregnant?
Many women with endometriosis conceive naturally, though the condition can reduce the chance of conception. Treatment options include pain control, surgery in selected cases, and assisted reproduction if needed. A gynaecologist can tailor an approach.
Can I get pregnant with one fallopian tube?
Yes. If the remaining tube is open and healthy and you ovulate on that side at least some cycles, pregnancy is possible. If you have not conceived after several months, ask your GP about tubal testing and referral.
What is unexplained infertility?
This means standard tests for ovulation, semen quality, tubes, and the uterus are normal. Timed sex, lifestyle measures, and options such as ovulation induction or intrauterine insemination may help. If months pass without success, IVF can be discussed.
How long should we try before seeing a specialist?
If under 35, see your GP at 12 months of trying. If over 35, book at six months. Your GP can refer you sooner if you have red flags such as amenorrhoea, severe period pain, or a history of pelvic infection.
Are fertility treatments covered by Medicare?
Medicare rebates apply to many investigations and parts of treatment when clinically indicated and referred. Out of pocket costs vary by clinic and your private health insurance. Ask for a written cost estimate before starting a cycle.
A Supportive Next Step
Trouble conceiving can feel isolating, yet it is common and often treatable. A clear plan usually starts with cycle tracking and a timely GP visit. Your GP can order the first tests, check thyroid and metabolic health, screen for STIs, and organise a semen analysis for your partner. Many couples conceive with lifestyle tweaks and simple treatments once a cause is found. If tests suggest a tubal or pelvic factor, or if time and age make it sensible, a referral to a fertility specialist adds more options.
At home tools can help you time sex and reduce guesswork. Ovulation tests are most useful when you pair them with a diary of your cycles. A pregnancy test from the day your period is due offers reliable confirmation so you can arrange early antenatal care. If your period does not arrive and tests are negative, repeat after 48 hours or speak with your GP. If you would like practical support while you test and track, explore our plain language guides and products that fit Australian practice. Small steps today can make the path to pregnancy feel more organised and less stressful.
References
https://www.healthdirect.gov.au/infertility
https://www.healthdirect.gov.au/fertility-and-conception
https://ranzcog.edu.au/patient-information/endometriosis
https://www.jeanhailes.org.au/health-a-z/pcos
https://www.jeanhailes.org.au/health-a-z/menstrual-cycle
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/amenorrhoea
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/endometriosis
https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/sex-health/guidelines/pid
https://www.health.gov.au/topics/pregnancy/trying-for-a-baby/fertility
Evan Kurzyp
Evan is the founder of Fertility2Family and is passionate about fertility education & providing affordable products to help people in their fertility journey. Evan is a qualified Registered Nurse and has expertise in guiding & managing patients through their fertility journeys.
