All articles
DocDocDash Clinical Team

Trying for a baby but nothing's happening?

IVF is most often recommended for blocked tubes, low sperm count, PCOS, endometriosis, low egg reserve or age, genetic conditions, and unexplained infertility. The signs of each, and the tests that confirm them.

  • Fertility
  • IVF
  • Pregnancy

Medically reviewed by Dr. William Aung, DocDocDash’s partner doctor network.
Last reviewed: October 2026.

Months of hoping, testing and waiting can feel exhausting, especially when no one can tell you why it isn’t happening. The good news is that most fertility problems have a clear cause, and a clear test to find it. IVF works by fertilising an egg in a lab and placing the embryo directly into the uterus, which lets it get around many of these problems.

IVF (in vitro fertilisation) is most often recommended for blocked fallopian tubes, low sperm count or quality, ovulation problems such as PCOS, endometriosis, low egg reserve or age, inherited genetic conditions, and unexplained infertility. Each can usually be checked with a simple blood test, ultrasound or semen analysis, so you can find out early whether IVF is likely to help.

7 Common Reasons Doctors Recommend IVF, and the Tests That Reveal Them

Below, we explain the most common reasons doctors recommend IVF, what signs to look out for, and which tests can give you answers.

1. Can blocked fallopian tubes stop you getting pregnant?

Yes. The fallopian tubes are where sperm meets egg. If they are blocked or damaged, sperm cannot reach the egg, or a fertilised egg cannot travel to the uterus. IVF skips the tubes completely, so it is often the most effective option for this problem.

Signs to look out for: Tubal problems are often “silent” with no symptoms. Risk factors include a past pelvic infection (pelvic inflammatory disease, or PID), chlamydia, an ectopic pregnancy, or previous pelvic or abdominal surgery.

Tests that give answers:

  • HSG (hysterosalpingogram): an X-ray in which a dye is passed through the cervix to see whether the tubes are open.
  • HyCoSy: a similar check done with ultrasound instead of X-ray.

2. Can IVF help with a low sperm count?

Yes. Fertility is a shared journey, and sperm problems play a part in many couples’ difficulties. Low sperm count, poor movement (motility) or an unusual shape (morphology) can make natural conception harder. IVF combined with ICSI (intracytoplasmic sperm injection), where a single healthy sperm is injected directly into each egg, greatly improves the chance of fertilisation.

Signs to look out for: There are usually no physical symptoms. Risk factors include hormone imbalances, past testicular injury or surgery, smoking, heavy drinking and some medications.

Test that gives answers:

  • Semen analysis: a simple, non-invasive test that checks sperm count, movement and shape. It is worth doing early, alongside the female partner’s tests.

3. Is IVF an option if you have PCOS?

Yes, though it is rarely the first step. With PCOS (polycystic ovary syndrome) and other ovulation problems, eggs are released irregularly or not at all. Doctors usually start with ovulation tablets such as letrozole or clomiphene, sometimes followed by IUI (intrauterine insemination). IVF is recommended when these do not lead to pregnancy, because it gives full control over egg growth and collection.

Signs to look out for:

  • Irregular, very long or missing periods
  • Persistent acne or excess facial and body hair
  • Weight gain or difficulty losing weight

Tests that give answers:

  • Hormone blood tests: including AMH, FSH, LH and testosterone.
  • Pelvic ultrasound: to look for the many small follicles typical of PCOS.

4. Does endometriosis mean you need IVF?

Not always, but it is a common reason for IVF. Endometriosis is when tissue similar to the womb lining grows outside the uterus. It most often appears on the ovaries, the fallopian tubes, the outer surface of the uterus, and the tissue lining the pelvis. It can cause inflammation and scarring that affect egg quality and block or damage the tubes. Some women with mild endometriosis conceive naturally or after surgery, while IVF is often advised for moderate to severe cases or when other treatments have not worked.

Signs to look out for:

  • Very painful periods that disrupt daily life
  • Ongoing pelvic pain, or pain during sex
  • Heavy periods or bleeding between periods

Tests that give answers:

  • Transvaginal ultrasound or MRI: these can now often diagnose endometriosis without surgery, particularly ovarian cysts (endometriomas) and deep disease.
  • Laparoscopy: keyhole surgery, used when scans are unclear or treatment is needed at the same time.

5. Is it harder to get pregnant after 35, and can IVF help?

Yes, fertility declines with age, and IVF can help, though it cannot fully reverse that decline. Egg numbers and quality fall gradually from the early 30s and more quickly after 37. Some women also have a lower egg supply than expected for their age, called diminished ovarian reserve (DOR). IVF lets doctors stimulate the ovaries to collect several eggs in one cycle and assess the embryos before transfer.

Signs to look out for: Many women notice nothing at all. Some find their cycles become shorter or their periods lighter.

Tests that give answers:

  • AMH (anti-Mullerian hormone) blood test: gives an estimate of how many eggs remain.
  • Antral follicle count (AFC): an ultrasound that counts the small follicles in each ovary.

If you are not ready for a baby yet, these same tests can help you decide whether egg freezing is worth considering.

6. Can IVF stop you passing on a genetic condition?

It can greatly reduce the risk for a specific known condition. If one or both partners carry a gene for a serious inherited condition (thalassaemia is common in many Asian communities), IVF can be combined with PGT-M (preimplantation genetic testing). Embryos are tested in the lab, and only those without that particular condition are chosen for transfer. PGT does not screen for every possible genetic problem, so your specialist may still suggest routine pregnancy screening.

Signs to look out for: Usually none. Carriers are typically healthy and may only find out after a family member is diagnosed or through screening.

Test that gives answers:

  • Carrier screening: a blood or saliva test for both partners, ideally before trying to conceive.

7. What if all your fertility tests come back normal?

This is called unexplained infertility, and it affects around a quarter of couples who have fertility tests. It can be frustrating, but it does not mean nothing can be done. Doctors often start with timed intercourse or IUI, and recommend IVF if pregnancy has not happened after a set period, or sooner if age is a concern. IVF can also reveal issues that standard tests miss, such as how eggs and sperm interact during fertilisation.

When should you see a fertility specialist?

Most guidelines recommend a fertility assessment based on your age and how long you have been trying:

Your situationWhen to get checked
Under 35After 12 months of regular, unprotected sex
35 to 39After 6 months
40 or olderStraight away, or after 3 months at most
Known risk factors (irregular periods, severe period pain, past pelvic infection or tubal surgery, known sperm issues)Straight away

Both partners should be tested at the same time. It saves months, and many of the tests above take less than an hour.

Frequently asked questions

Is IVF painful? Most women describe the hormone injections as a small pinch. Egg collection is done under sedation, and mild cramping for a day or two afterwards is common.

How long does one IVF cycle take? From the start of hormone injections to embryo transfer usually takes about 2 to 3 weeks. Planning the whole trip, including tests and consultations, often takes 4 to 6 weeks.

Do both partners need to be tested before IVF? Yes. Testing both partners together gives a full picture and avoids delays, since sperm factors contribute to many cases.

Can I do the first tests in my home country and treatment overseas? Often, yes. Many basic tests, such as AMH blood tests and semen analysis, can be done locally and shared with your overseas clinic before you travel.

Not sure where to start? DocDocDash can help you compare fertility screening packages and IVF clinics with clear pricing and support in your language.

Sources:

  • American Society for Reproductive Medicine (ASRM): definitions of infertility and when to seek evaluation
  • NICE guideline CG156: Fertility problems, assessment and treatment (UK), including unexplained infertility
  • ESHRE guideline: Endometriosis (2022), on diagnosis by imaging versus laparoscopy
  • RANZCOG (Australia and New Zealand) patient information on fertility and IVF
  • ESHRE good practice recommendations on preimplantation genetic testing (PGT)