When to start IVF: knowing the right time to seek fertility support

On this page:

When should you seek fertility help?

Signs you should consult a fertility specialist earlier

Special considerations: endometriosis and gynecological conditions

Fertility treatment options available in Portugal

Understanding the costs of fertility treatment

The emotional reality of fertility treatment

Factors that can affect treatment success

Common myths about fertility and IVF

Breaking the taboos around fertility treatment

Taking the next step

When should you seek fertility help?

The standard guidance is clear: if you’ve been trying to conceive naturally for 12 months without success, it’s time to consult a specialist. But this timeline changes based on your circumstances.

Dr. Carvalho says that early consultation often makes a real difference.

“Simple interventions can often make a significant difference in just a few weeks.”

Signs you should consult a fertility specialist earlier

Certain factors mean you should seek specialist advice before the usual waiting period. These aren’t reasons to worry, but they are reasons to act.

Age is the most significant factor. If you’re over 35, your fertility timeline is naturally shorter. Egg quality and quantity (ovarian reserve) decline with age, which is why the recommendation shifts to 6 months of trying instead of 12 months.

Menstrual irregularities matter. Irregular cycles, absent periods, or abnormal uterine bleeding can signal underlying issues affecting ovulation and conception. These are worth investigating sooner rather than later.

Previous medical history provides important clues. If you’ve had pelvic surgery, been diagnosed with endometriosis, experienced recurrent pelvic infections, or have a family history of gynecological cancer, earlier evaluation helps identify any obstacles to conception.

Male fertility matters just as much. Changes in sperm quality or quantity can seriously affect your chances of conceiving naturally. Read our guide to improving sperm quality naturally.

These conditions don’t mean you’ll definitely need IVF. They just mean getting checked out early can save you months of uncertainty and help you figure out the best path forward.

Special considerations: endometriosis and gynecological conditions

Dr. Carvalho recommends beginning gynecological monitoring if you experience severe menstrual pain (dysmenorrhea) or have irregular periods. Regular screening allows your doctor to identify potential fertility issues before they become more complex.

If you’ve been diagnosed with endometriosis or suspect you might have it, the timing of seeking fertility support becomes even more important.

Endometriosis affects fertility in multiple ways. It can:

• create inflammation that affects the way egg and sperm interact
• damage the fallopian tubes or ovaries
• cause scarring or adhesions that affect how your reproductive organs work
• reduce egg quality, especially if endometriomas are present (this is a type of ovarian cyst formed when endometrial tissue grows in the ovaries)
• make sex painful, which may lead to less frequent intercourse

The earlier these factors are identified and managed, the better your chances of conceiving, whether naturally or through fertility treatment.

Remember: you don’t need to wait until you’re actively trying to conceive. If you know you have a condition that may affect fertility, speaking with a specialist about your timeline and options is worth doing, even if pregnancy is still a few years away.

Fertility treatment options available in Portugal

Knowing what treatments are out there helps you feel more prepared when you speak with a specialist. Portugal has all the major fertility treatment options available, each one suited to different situations.

Intrauterine insemination (IUI)

IUI is often the first step in fertility treatment. It’s a relatively simple procedure where carefully selected, pre-treated sperm (either your partner’s or a donor’s)  is placed directly into the uterus around the time of ovulation.

When IUI is recommended:

• Mild male infertility factors
• Unexplained infertility
• Cervical mucus issues
• Same-sex couples or single women using donor sperm

The process is less invasive than IVF and can be a good starting point for many couples, especially for women under 35.

In vitro fertilization (IVF)

IVF is generally recommended when other methods haven’t been successful or when more complex fertility problems are identified. The IVF process involves stimulating the ovaries to produce multiple eggs, collecting those eggs, fertilising them in the laboratory, and transferring resulting embryos back to the uterus.

Common situations where IVF is recommended:

• Blocked or damaged fallopian tubes
• Moderate to severe male infertility
• Endometriosis affecting fertility
• Unexplained infertility after other treatments
• Advanced maternal age
• Multiple failed IUI cycles

IVF success rates depend on your individual situation, but laboratory techniques keep getting better, which means outcomes are improving.

Donor conception

IVF can be performed using donor eggs or donor sperm when one partner can’t use their own eggs or sperm. This opens the possibility of parenthood to many people who otherwise couldn’t conceive, including same-sex couples, single parents, and those with medical conditions affecting their fertility. Find out more about our donor program at Ferticentro.

Preimplantation genetic testing (PGT)

PGT lets doctors check embryos for genetic conditions before they’re transferred to your uterus. This matters most for couples with known genetic conditions, recurrent miscarriage, or repeated IVF failure.

The technology helps pick embryos with the best chance of a healthy pregnancy, but it’s not right for everyone.

Read our guide on the different types of embryo screening to learn more.

Understanding the costs of fertility treatment

Fertility treatment is a financial investment, but Portugal offers more accessible options than many people realize.

Public funding in Portugal

Women up to age 40 who meet the criteria can access Reproduction Centers in National Health Service hospitals. This covers up to three cycles of IVF or other recommended treatments.

The public system provides high-quality care, but waiting times can be longer than some couples want to wait, especially when age matters.

Private fertility treatment

When public funding runs out, or if you want to move forward more quickly, private fertility centers are another option.

Portugal’s private fertility treatment costs are much lower than many other countries. IVF in Portugal often costs half or even a third of what it costs in the UK or US. This makes treatment accessible not just for Portuguese residents but for international patients too.

At Ferticentro, we’re upfront about pricing from the start, so you can plan your journey without financial surprises.

The emotional reality of fertility treatment

The physical side of fertility treatment gets most of the attention, but the emotional journey matters just as much.

Dr. Carvalho notes that psychological support is part of Ferticentro’s approach.

Our psychologist specializing in fertility works closely with patients, helping them manage the emotional challenges of treatment, develop coping strategies, and feel supported at every stage of the process.

Common emotional challenges

The concerns patients share most often include:

• Fear of treatment failure
• Impact on the relationship
• Struggling with uncertainty
• Pressure around timing
• Grief from previous losses
• Anxiety about using donor eggs or sperm

These feelings are normal. Fertility treatment involves hope, disappointment, waiting, and often multiple attempts. You shouldn’t have to face this alone.

Emotional care matters just as much as medical care when you’re building a family. Having professional psychological support means you don’t have to carry the weight of the process by yourself.

Staying connected as a couple during treatment

Fertility treatment can strain even the strongest relationships. The process is long, emotionally demanding, and full of uncertainty. Feeling overwhelmed is completely natural.

Practical ways to maintain your connection

Dr. Carvalho offers practical advice for couples navigating this journey:

Build a support network. Whether it’s friends, family, support groups, or a therapist, talking to people who understand or who just know how to listen makes a huge difference. You don’t have to explain everything to everyone, but having somewhere to turn matters.

Trust your medical team. “Trying to control every outcome only increases stress levels,” Dr. Carvalho explains. “Trusting that you are being cared for by an experienced team allows the couple to focus on each other, rather than being consumed by the pressure of the process.”

Be kind to each other. “You are on the same side,” she emphasizes. Choose empathy over blame. Take breaks when you need them. Create moments of joy that have nothing to do with fertility. These things aren’t extras – they’re essential.

Keep communication open. Assumptions about what your partner is thinking or feeling create distance. Check in with each other regularly. Sometimes that conversation is about treatment, sometimes it’s about anything but. Both matter.

The journey through fertility treatment will change your relationship. With intention and care, it can make you stronger instead of pulling you apart.

Factors that can affect treatment success

Even with medical support, pregnancy isn’t guaranteed. Fertility treatments are powerful, but they don’t work for everyone every time. Understanding what can affect success helps you set realistic expectations.

Implantation failure

Sometimes an embryo that looks healthy fails to implant in the uterus. This can be down to:

• embryonic factors
• uterine factors
• immunological issues
• or problems at the cellular level

Ferticentro uses advanced diagnostic tools to investigate implantation failure when it happens repeatedly. Each case is different, and identifying the specific issue allows for targeted treatment.

Poor response to ovarian stimulation

Some women don’t respond to stimulation medication as expected, which means fewer eggs get collected. This can be frustrating, but it’s not the end of the road.

Dr. Carvalho explains: “We carefully adjust the stimulation protocols based on the hormonal profile and response history of each woman, making it possible to accumulate oocytes in particular cases.”

Protocols can be changed between cycles. Sometimes collecting fewer eggs over multiple cycles gives better overall outcomes than pushing for higher numbers in a single go.

The role of lifestyle factors

Lifestyle factors like diet, smoking, alcohol, stress, and exercise all affect fertility, but their impact is often overblown.

• Smoking reduces the quality of both eggs and sperm. If you smoke, quitting improves your fertility and treatment outcomes.
• Excessive alcohol disrupts hormonal balance. Cutting back during treatment makes sense, but you don’t need to eliminate every glass of wine to conceive.
• Chronic stress can interfere with ovulation and sexual function. Finding ways to manage stress helps, though telling someone trying to conceive to “just relax” is unhelpful and inaccurate. Find stress management strategies that actually work for you.
• Poor diet and lack of exercise affect weight and metabolic health, both of which influence fertility. But you don’t need to be perfect.

Dr. Carvalho puts it well: “Small adjustments can support fertility and improve treatment outcomes, but it is not necessary to be perfect. The goal is progress, not perfection.”

Lifestyle factors are rarely the only cause of infertility. They’re worth addressing, but they’re not the whole story.

Common myths about fertility and IVF

Misconceptions about fertility and assisted reproduction create unnecessary fear and stop many couples from seeking help when they need it.

Myth: Getting pregnant is easy at any age

Many people overestimate how easy it is to conceive and underestimate how quickly fertility drops with age. Waiting until your late thirties or after forty seriously reduces your chances of natural conception and increases the likelihood you’ll need fertility treatment.

This isn’t about pressure or judgment. It’s about having accurate information to make informed decisions about your timeline.

Myth: IVF is only for last resort cases

Fertility treatments are often seen as overly complex, invasive, or only for desperate situations. The truth is, early consultation and support can make a real difference.

IVF isn’t a failure of your body or your relationship. It’s a medical tool that helps millions of people become parents.

Myth: Miscarriage is rare and means something is seriously wrong

Miscarriage is common and often a neglected part of the fertility journey. It carries a huge emotional impact and deserves proper support and acknowledgment.

Having a miscarriage doesn’t mean you won’t have a successful pregnancy. It does mean you should get appropriate medical follow-up and emotional support.

Breaking the taboos around fertility treatment

Fertility treatments used to be sensitive or even taboo subjects, but they’re much more widely accepted today. About 1 in 6 couples face fertility difficulties, and growing numbers use fertility treatments.

Almost everyone now knows someone who’s been through treatment or who is a parent because of it. This familiarity reduces stigma and makes it easier to seek help.

Dr. Carvalho believes continued education is key: “When people feel comfortable talking about these issues, they are more likely to seek expert advice in a timely manner, which can significantly improve the chances of success.”

Less stigma helps people feel supported and encourages them to get help sooner. Both improve outcomes for couples facing fertility challenges.

Taking the next step

If you’ve been wondering whether now is the right time to seek fertility support, the answer is probably yes.

Seeing a specialist doesn’t commit you to treatment. It gives you information about your specific situation, your options, and your timeline. That knowledge helps you make decisions from a place of clarity instead of uncertainty.

At Ferticentro, the team understands that starting this journey takes courage. You’ll be supported by experienced clinicians who combine medical expertise with genuine empathy for what you’re going through.

Whether you’re just starting to explore your options or you’re ready to begin treatment, reaching out is the first step. You don’t have to do this alone. Contact us to book your initial consultation.