Initial advice to people concerned about delays in conception

1.4 Chance of conception

1.4.1

Inform people who are concerned about their fertility that over 80% of heterosexual couples in the general population will conceive within 1 year if:

the woman is aged under 40 years, and
they do not use contraception and have regular vaginal sexual intercourse.

Of those who do not conceive in the first year, about half will do so in the second year (cumulative pregnancy rate over 90%). See table 1 for the cumulative probability of conceiving a clinical pregnancy by the number of menstrual cycles – sexual intercourse. [2004, amended 2013]

1.4.2

Inform people who are using artificial insemination to conceive and who are concerned about their fertility that:

47% to 57% (depending on age) of women aged under 40 years will conceive within 6 cycles of intrauterine insemination (IUI)
of those who do not conceive within 6 cycles of IUI, about half will do so with a further 6 cycles (cumulative pregnancy rate of 72% to 81%, depending on age).

See table 2 for the cumulative probability of conceiving a clinical pregnancy by the number of cycles of insemination – intracervical insemination (ICI) and IUI. [2013, amended 2026]

1.4.3

Inform people who are concerned about their fertility that female fertility and (to a lesser extent) male fertility declines with age. See figure 1. [2013, amended 2026]

Figure 1 The effect of maternal age on pregnancy rate

Figure based on data reported in Steiner and Jukic (2016), a prospective cohort study including women aged 30 to 44 years with no known fertility problems showing cumulative pregnancy rate (with 95% confidence interval) over 12 menstrual cycles of attempting to conceive spontaneously.

1.4.4

Discuss the chances of conception with people concerned about their fertility who are:

having unprotected vaginal sexual intercourse (see table 1), or
using artificial insemination (see table 2). [2013, amended 2026]

**Table 1 Cumulative probability of conceiving a clinical pregnancy by the number of menstrual cycles – sexual intercourse**
Maternal age	Pregnant after 1 year or 12 cycles	Pregnant after 2 years or 24 cycles
19 to 26 years	92%	98%
27 to 29 years	87%	95%
30 to 34 years	86%	94%
35 to 39 years	82%	90%

Cumulative probability of conceiving a clinical pregnancy by the number of menstrual cycles attempting to conceive in different age categories (assuming vaginal intercourse occurs twice per week). Reproduced with permission: Dunson DB, Baird DD, Colombo B (2004). Increased infertility with age in men and women. Obstetrics and Gynecology 103: 51–6.

**Table 2 Cumulative probability of conceiving a clinical pregnancy by the number of cycles of insemination – intracervical insemination (ICI) and intrauterine insemination (IUI)**
Maternal age	Intracervical insemination (ICI) using thawed semen – 6 cycles (Schwartz 1982)	ICI using thawed semen – 12 cycles (Schwartz 1982)
Under 30 years	50%	70%
30 to 34 years	43%	62%
Over 34 years	33%	54%
Maternal age	ICI using fresh semen – 6 cycles (Zaadstra 1991)	ICI using fresh semen – 12 cycles (Zaadstra 1991)
Under 31 years	58%	76%
31 to 35 years	50%	71%
Over 35 years	39%	55%
Maternal age	Intrauterine insemination (IUI) using donor sperm – 6 cycles (theoretical cumulative pregnancy rate using HFEA data from 1991 to 2023)*	IUI using donor sperm – 12 cycles (theoretical cumulative pregnancy rate using HFEA data from 1991 to 2023)*
18 to 34 years	57%	81%
35 to 37 years	54%	78%
38 to 39 years	47%	72%
40 to 42 years	31%	52%
43 to 44 years	17%	31%
Over 44 years	6%	11%

* Data for IUI is based on donor insemination and was obtained from the Human Fertilisation and Embryology Authority (HFEA) dashboard (HFEA 2023). This includes donor insemination treatments between 1991 and 2023 (data for 2020 to 2023 is preliminary), and includes both unstimulated and stimulated IUI. Pregnancy rates for IUI in health-related fertility problems may be lower than the rates for donor insemination. The percentages describe life table analysis estimates of cumulative clinical pregnancy probability over 6 and 12 cycles of donor insemination, derived from per-cycle probabilities.

1.5 Frequency and timing of sexual intercourse or artificial insemination

1.5.1

Inform people who are concerned about their fertility that vaginal sexual intercourse every 2 to 3 days optimises the chance of pregnancy. [2004, amended 2013]

1.5.2

People who are using artificial insemination to conceive should have their insemination timed around ovulation. [2013]