Written by Dr Sam Saling for AJFN

Life sometimes doesn’t go to plan. Pregnancies sometimes don’t go to plan. That’s why we are here to help.

First, start with your already established team. Your partner is the number one person who is holding your hand throughout this entire journey. Sit down and have a discussion about where to go next. Most likely, they are feeling the same way you are. Confused, let down, uncertain about the future. It can be comforting that you are not alone on this journey.

Next, consider what infertility (we prefer the term subfertility) actually is and the guidelines (but we recognise these are just guidelines, and not real life).

The definitions the guidelines use: Subfertility is the failure to conceive after six months (for a female aged over 35 years), or 12 months (for a female aged under 35 years) of regular unprotected intercourse. More than three quarters of couples wanting to conceive will do so within 12 months. Despite this, subfertility affects 1 in 6 couples trying to conceive.

The causes?

40% due to female factors, such as

  • Ovulatory dysfunction
  • Uterine anomalies
  • Tubal abnormalities
  • Endometriosis
  • And more

40% due to male factors

  • Sexual dysfunction
  • Semen anomalies
  • And more

20% due to combined or unknown factors

For women, age is the number one factor affecting their ability to conceive, no matter the method. Fertility rapidly declines from age 35, markedly so after age 40. The biological clock is cruel.

Once you have confronted this reality, the next step would be to see your GP. They are your grassroots, first point of contact to the medical system that can at times be overwhelming and isolating. We encourage finding a GP you like and get along with, for long term care.

There are many, many wonderful medical technological advancements that have changed the fertility space over the past few decades. This includes pharmacological agency (e.g. medications to for example help with ovulation), assisted reproductive technology like IVF, and even egg donation. 

The acronyms you may come across:

ART: Assisted reproductive technology

IVF: In vitro fertilisation

IUI: Intrauterine insemination

Check out the AJFN Fertility Zone website. Here, we’ve compiled a wealth of resources for your benefit, to learn all about fertility and subfertility, and support your journey.

Resources we recommend:

Jean Hailes:


Your IVF Success:


About Dr Sam Saling

Dr Sam Saling is a general practitioner in inner Sydney. Her clinical interests include women’s health, in particular reproductive and antenatal care, child health, and dermatology. Outside of clinical practice she has held advocacy roles through the Australian Medical Association, and undertakes medical communication and strategy work for private enterprise and not-for-profit organisations.

Samantha has seen firsthand how devastating fertility issues can affect families, and it is a privilege to accompany her patients on this journey. She is honoured to have served on the AJFN board in 2023 as Board Observer and is passionate about using her medical knowledge to assist AJFN and the community at large.

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