We've been trying for a while — when should we actually see a doctor?

The usual guide is to seek assessment if you're under 35 and have been trying for about a year, or over 35 and have been trying for around six months. The earlier timeline for women over 35 matters because fertility declines with age, so there's less time to spare. You don't have to wait, though — if you already know there's a reason to be concerned (irregular periods, a past pelvic infection, a known issue), it's reasonable to see your GP sooner. Trouble conceiving is common and affects a large share of couples, so it's a routine thing to raise.

What's the difference between IUI and IVF, and which comes first?

They're different rungs on a ladder. IUI (intrauterine insemination) places prepared sperm directly into the uterus around ovulation, often with mild ovary stimulation — it's simpler and less expensive. IVF (in vitro fertilisation) collects eggs, fertilises them in the lab, and transfers an embryo — more involved and more costly, but more effective for many situations. The usual approach moves from optimising health and timing, to investigation, to IUI, then IVF if needed — but the right starting point depends on the cause. For blocked tubes, severe male-factor problems, or older age, a specialist may recommend going straight to IVF.

How much does age really affect our chances, including with IVF?

A lot — female age is the single biggest factor. Natural fertility declines slowly from the early 30s and more steeply from about 35, as egg numbers and quality fall; male fertility also declines, particularly after 40. Crucially, age affects IVF success too: it's the most important factor in the chance of IVF leading to a baby. This is why the advice to seek help sooner if you're over 35 isn't about pressure — it's about giving treatment the best chance to work. Your GP can talk through what this means for your situation.

Will a vasectomy change my sex drive or how I feel?

No — a vasectomy doesn't affect testosterone, libido, erections or the experience of sex. It only stops sperm from being part of the semen; everything else works as before. This is one of the most common worries men raise, and the reassurance is genuine. What it does change is fertility, and because that change should be considered permanent, the real work of the decision is being sure about not wanting (more) biological children — which is exactly what to think through and discuss with your GP.

Decision aid

Fertility and family-planning decisions

By Dr HB Lo, FACRRM Reviewed 15 June 2026 4 min read

General information to help you prepare for your GP — not a diagnosis, not personal medical advice. It doesn't replace a consultation, and using it doesn't create a doctor–patient relationship.

Family-planning decisions sit at two ends of a spectrum: trying to start a pregnancy, and choosing to stop. Both deserve clear, unhurried information.

If conceiving is taking longer than hoped, there's a stepwise path — optimising health and timing, then investigation, then treatments like IUI or IVF — and the right entry point depends a lot on the cause and, above all, on age. At the other end, a vasectomy is a safe, highly effective and essentially permanent form of contraception, but "permanent" is the word that makes it a decision worth taking time over.

This guide explains how each of these is weighed, so you can take clear questions to your GP.

Two decisions at opposite ends — both deserve unhurried information

Family planning covers two very different conversations: the one where you’re trying hard to start a pregnancy and it isn’t happening, and the one where you’ve decided you’re done and want it to stay that way. They feel nothing alike, but they share something — both are easier to navigate when nobody’s rushing you, and both reward knowing how the options actually stack up.

This guide walks through both: the stepwise path when conceiving is difficult, and the vasectomy decision. The aim is to take clear questions to your GP rather than wrestle with it alone.

When trying isn’t working: when to ask for help

The first thing many couples want to know is simply when it’s reasonable to seek help. The usual guide is to be assessed if you’re under 35 and have been trying for about a year, or over 35 and have been trying for around six months, as HealthDirect sets out. Trouble conceiving is common — it affects a large share of couples — so raising it is routine, not unusual.

The shorter timeline for women over 35 isn’t about pressure; it reflects biology. And if you already have a reason to be concerned — irregular periods, a past pelvic infection, a known issue — it’s fine to see your GP sooner.

Why age sits at the centre of all of it

The single most important factor in natural fertility, and in how well treatment works, is age — particularly female age. Fertility declines slowly from the early 30s and more steeply from around 35, as egg numbers and quality fall, with male fertility also declining especially after 40, per Your Fertility, the government-funded fertility program. This matters for treatment too: female age is the most important factor in the chance of IVF leading to a baby, as the Better Health Channel states plainly.

That’s the real reason behind “seek help sooner if you’re over 35” — it gives any treatment the best chance to work. Jean Hailes offers good Australian background on fertility and the conversation worth having early.

The treatment ladder: keep trying, IUI, IVF

When help is needed, there’s a recognisable ladder, described by HealthDirect and the Better Health Channel:

Optimise health and timing first — the foundations of weight, smoking, alcohol and understanding the fertile window.
Investigation — finding whether there’s a specific cause (ovulation, tubes, sperm, or unexplained).
IUI (intrauterine insemination) — prepared sperm placed directly into the uterus around ovulation, often with mild ovary stimulation; simpler and less expensive.
IVF (in vitro fertilisation) — eggs collected, fertilised in the lab, an embryo transferred; more involved and more costly, but more effective for many situations.

Importantly, this isn’t a fixed escalator everyone climbs from the bottom. For blocked tubes, severe male-factor problems, or older age, a specialist may recommend going straight to IVF. IVF is partly Medicare-rebated but still carries substantial out-of-pocket costs, per the Better Health Channel. The way the definition of infertility and access to treatment is framed continues to evolve in Australia, as RANZCOG has discussed. The fertility treatment options decision aid below helps you see where you might sit on this ladder and prepare the questions — it doesn’t choose a treatment for you.

The vasectomy decision: safe and effective, but treat it as permanent

At the other end of family planning is the vasectomy — a quick procedure, usually under local anaesthetic, that cuts or blocks the tubes carrying sperm. It’s one of the most reliable forms of contraception, and it doesn’t affect testosterone, libido, erections or the experience of sex, as HealthDirect and Healthy Male make clear. The common worry that it will “change something” is genuinely unfounded — it only stops sperm being part of the semen.

Two honest points anchor the decision. First, it isn’t immediate: it takes a few months to clear, and a semen test confirms it has worked, so other contraception is needed until then, per the Better Health Channel. Second, and most importantly, you should treat it as permanent. Reversal is sometimes possible, but it isn’t guaranteed, becomes less likely the longer ago the vasectomy was done, and is generally not funded, as Healthy Male explains. So the real work of the decision is being sure about not wanting (more) biological children. The vasectomy decision aid below is built to help you think that through and prepare the conversation with your GP.

The questions worth taking in

Given our ages and how long we’ve been trying, is it time to investigate — and what would that involve?
If treatment is needed, would starting with IUI or going straight to IVF make more sense for our situation?
What would treatment realistically cost and involve for us?
If I’m considering a vasectomy, am I treating it as permanent — and what does the process and confirmation involve?

These are questions, not conclusions. The aim is to decide with your GP.

What this is, and is not

This is general information to help you prepare for your GP — not a diagnosis, and not personal medical advice. It doesn’t tell you which treatment to pursue or whether to have a procedure; those decisions are made with your own doctors. For trustworthy Australian background, see HealthDirect and Your Fertility.

Related on this site: the PCOS explainer covers a common cause of difficulty conceiving, and the contraception decision aid sits at the other end of the same family-planning conversation.

If you want a thorough, unhurried discussion of your own fertility or family-planning picture, you can work with Dr Lo.

Author: Dr Hoe Bing Lo — AHPRA MED0001212640 · FACRRM. Fun Doctors Pty Ltd · ABN 83 404 436 330.

Tools to take to your GP

Each runs in your browser — nothing you enter is stored or sent anywhere. They help you prepare the questions and print a one-page summary to bring to your appointment. They don't diagnose or recommend a specific treatment.

Frequently asked questions

We've been trying for a while — when should we actually see a doctor?

The usual guide is to seek assessment if you're under 35 and have been trying for about a year, or over 35 and have been trying for around six months. The earlier timeline for women over 35 matters because fertility declines with age, so there's less time to spare. You don't have to wait, though — if you already know there's a reason to be concerned (irregular periods, a past pelvic infection, a known issue), it's reasonable to see your GP sooner. Trouble conceiving is common and affects a large share of couples, so it's a routine thing to raise.
What's the difference between IUI and IVF, and which comes first?

They're different rungs on a ladder. IUI (intrauterine insemination) places prepared sperm directly into the uterus around ovulation, often with mild ovary stimulation — it's simpler and less expensive. IVF (in vitro fertilisation) collects eggs, fertilises them in the lab, and transfers an embryo — more involved and more costly, but more effective for many situations. The usual approach moves from optimising health and timing, to investigation, to IUI, then IVF if needed — but the right starting point depends on the cause. For blocked tubes, severe male-factor problems, or older age, a specialist may recommend going straight to IVF.
How much does age really affect our chances, including with IVF?

A lot — female age is the single biggest factor. Natural fertility declines slowly from the early 30s and more steeply from about 35, as egg numbers and quality fall; male fertility also declines, particularly after 40. Crucially, age affects IVF success too: it's the most important factor in the chance of IVF leading to a baby. This is why the advice to seek help sooner if you're over 35 isn't about pressure — it's about giving treatment the best chance to work. Your GP can talk through what this means for your situation.
Is a vasectomy permanent — and what does the procedure actually involve?

A vasectomy is a quick procedure, usually done under local anaesthetic, that cuts or blocks the tubes carrying sperm. It's very effective and is the most reliable contraception for men — but you should treat it as permanent when deciding. Reversal is sometimes possible, but it's not guaranteed, becomes less likely the longer ago the vasectomy was, and is generally not funded. It also isn't immediate: it takes a few months to clear, and a semen test confirms it has worked, so other contraception is needed until then. It doesn't affect hormones, libido or sexual function, and it doesn't protect against sexually transmitted infections.
Will a vasectomy change my sex drive or how I feel?

No — a vasectomy doesn't affect testosterone, libido, erections or the experience of sex. It only stops sperm from being part of the semen; everything else works as before. This is one of the most common worries men raise, and the reassurance is genuine. What it does change is fertility, and because that change should be considered permanent, the real work of the decision is being sure about not wanting (more) biological children — which is exactly what to think through and discuss with your GP.

Source quality

Sources grouped by evidence tier. Australian primary tier first; international where Australia is silent or lagging. How tiers work.

T1 AU primary 9 sources

If you want a thorough, unhurried work-up of your own — not a generic answer — you can work with Dr Lo.