You're thinking about a baby — perhaps you've already stopped taking the pill and you're watching for that positive test like a train that's running late. But conception can't be ordered on demand. In the UK, around one in seven couples take longer than a year to conceive. That figure doesn't solve anything, but it helps you focus on what happens before pregnancy — and stops you believing it only happens to other people.

Smoking is the first risk factor to tackle

What we know: smoking reduces fertility in both partners. In men, cigarettes affect sperm quality. In women, smoking draws down the ovarian reserve — and the earlier you started, the sooner that reserve can become depleted. Current evidence also suggests an effect on implantation, when the embryo embeds in the lining of the womb. Stopping even a few months before you start trying gives the couple a better chance.

Cigarette end stubbed out in a stone ashtray on a balcony ledge
Stopping smoking a few months before you start trying already changes things

Stress can get in the way, but it isn't fate

Let's be honest: tension isn't something you choose. Work, anxiety, your relationship, the all-consuming wish for a child… there are plenty of sources. Stress is often linked to lower chances of conceiving, but whether it plays a causal role is still debated; reducing it may mainly improve your wellbeing. There are simple levers, though: exercise, a hobby, proper breaks where you think about nothing at all. And one thing to avoid: scheduling every sexual encounter around ovulation. A relationship that becomes a timetable quickly becomes a relationship under pressure — and no one benefits from that.

Young woman walking in a park, phone tucked away in her pocket
Walking, switching off, breathing: stress also releases through the body

STIs still matter

Chlamydia and gonorrhoea: these sexually transmitted infections often go unnoticed and can leave lasting damage to fertility. For prevention, condoms remain the gold standard, and testing is available without a GP referral at sexual health clinics; some laboratory tests may require a referral or have age limits. Keep up regular gynaecological check-ups too. In the UK, cervical screening is offered by the NHS every three years between the ages of 25 and 49, then every five years between 50 and 64. It is free, and samples are first tested for HPV.

Unscented solid soap on a ceramic dish by the sink
Condoms remain the gold standard against STIs

A small detail that matters: scented intimate hygiene products and douches are not recommended. A mild, unscented soap does the job perfectly well. If you want to cut down on packaging, a solid format or a refill in bulk is an option — as long as the formula is short and unscented.

Age matters, even if it's uncomfortable to hear

The average age at childbirth in the UK is around 31. Female fertility begins to decline from the early thirties, and the slope steepens noticeably after 35. That doesn't mean everything stops at 38, but it does mean time is against you — all the more so if you're hoping for more than one child.

Woman in her thirties standing thoughtfully by a window
Fertility declines from the early thirties, more noticeably after 35

When should you seek help?

The accepted rule is simple: ask for advice after twelve months of trying without contraception, and after six months if you are over 35. The assessment includes a consultation, examinations and often a semen analysis. It is the doctor who interprets the results and decides what happens next: no single test replaces their advice. A diagnosis is made with a professional, not on a forum.

Young woman writing her questions in a notebook before an appointment
After twelve months of trying, or six months if you are over 35, see your GP

In practice, remember this: stop smoking before you start trying; don't turn every sexual encounter into an ovulation calculation; get tested for STIs; see your GP after twelve months of trying, or six months if you are over 35. And for anything to do with your fertility, speak to a healthcare professional.

What it costs

In the UK, a GP appointment is free on the NHS. If you are referred, a semen analysis may be available on the NHS; privately, it often costs around £100–£200, depending on the clinic. Further tests — ultrasound scans, hormone tests — are usually done through a referral and follow the same pattern: available on the NHS, or privately for a fee. Fertility treatment on the NHS is not universally free. Eligibility and the number of cycles offered vary by local integrated care board. NICE guidelines recommend up to three cycles of IVF for women under 40, but many areas offer fewer. Private IVF costs several thousand pounds per cycle. Access for single women and female couples also depends on local policies.