When to refer for fertility treatment and preservation

Because fertility in all people declines naturally with age, refer for expert advice if conception has not occurred after trying for:

• 1 year if the female is 35 years or younger
• 6 months if the female is older than 35 years (because treatment success diminishes with age).

Earlier referral is indicated if known causes of or predisposing factors to infertility exist.

Consider referral for fertility preservation in situations such as:

• before treatment for some cancers
• before gender-affirmation treatment; see the TransHub website for information on fertility in transgender and gender diverse people
• for social reasons.

Units accredited for fertility treatment and preservation in Australia and New Zealand are listed on the Fertility Society website.

Additional support in dealing with the psychological impact of infertility or at-risk fertility may help reduce distress and improve pregnancy outcomes. Offer patients an opportunity to discuss their feelings, and consider referral to a mental health professional.