Infertility: When to See a Doctor and Which Tests for the Couple

A year of trying, then fifteen months, then eighteen. Each end of a cycle brings its disappointment, and the family begins to ask questions. If you are wondering whether this is infertility, know first that you are far from alone: according to the World Health Organization, about one in six people of childbearing age faces it during their lifetime.

In Morocco, a survey by the Société marocaine de médecine de la reproduction (SMMR), relayed by EcoActu in January 2021, estimated that 11.8% of couples had difficulty conceiving. Yet the subject is still rarely discussed in the family. Here are the benchmarks for when to see a doctor, and what the tests will actually look for, in you and in your husband.

Infertility: what exactly are we talking about?

The WHO defines infertility as the absence of pregnancy after 12 months or more of regular, unprotected sex. It is called primary when there has never been a pregnancy, secondary when there has been at least one, including if a first child was born without difficulty.

Morocco's law 47-14 on assisted reproduction takes up the same idea: it speaks of 'absence of pregnancy after 12 months of regular attempts to conceive naturally'.

Infertility does not mean sterility. Most couples affected have reduced fertility, not none. The NHS reminds us that more than 8 in 10 couples, when the woman is under 40, conceive within a year if they have sex every 2 or 3 days. To aim at the right time more precisely, our guide to spotting your fertile days can help during the first months.

How long before you see a doctor?

In July 2026, France's Haute Autorité de santé (HAS) clarified the timings. They match those of most professional societies.

Situations that justify seeing a doctor straight away include:

• very irregular cycles or no periods;
• very painful periods, which suggest endometriosis;
• a past genital infection or pelvic surgery;
• in men, testicular surgery, a testicular injury or heavy treatment such as chemotherapy.

Age weighs mostly on the female side, because the number and quality of eggs decline over the years. Our article on fertility by age details what changes at 30, 35 and 40.

What are the most common causes?

A cause can lie with the woman, the man, both at once, or remain unfound. The NHS estimates that no cause is identified in about a quarter of cases.

On the female side, the WHO lists:

• ovulation disorders, including polycystic ovary syndrome (PCOS);
• blocked or damaged tubes, often after an untreated sexually transmitted infection or surgery;
• womb abnormalities: fibroids, a septum, endometriosis;
• hormonal disorders of pituitary origin.

On the male side, the causes are mainly too few, poorly mobile or misshapen sperm, a blocked duct, a varicocele or a hormonal imbalance. According to the Mayo Clinic, a male factor plays a part, at least partly, in up to half of infertile couples.

Smoking, alcohol, overweight and certain pollutants affect both partners, the WHO notes. What belongs on the plate is sorted in our article on foods and fertility.

Which tests for the woman?

The female work-up answers three questions: do I ovulate, what is my egg reserve, and is the route clear (womb and tubes)?

AMH causes a lot of worry, wrongly. The Strasbourg university hospital document sums it up well: outside assisted reproduction, it is not recommended for predicting the chances of a birth. It mostly tells you how the ovaries respond to stimulation.

For the tubes, hysterosalpingography remains the first-line test. An ultrasound alternative, HyFoSy, gives comparable results and hurts a little less, but fails more often for technical reasons. A hysteroscopy or laparoscopy only come afterwards, if the history or the first tests justify it.

And for the man: the semen analysis first

The first male test is the semen analysis, usually accompanied by a semen culture looking for infection. The sample is collected at the laboratory after a few days' abstinence. It is a simple, painless test, best done at the start rather than after months of female tests.

If the result is abnormal, the doctor examines the testicles and refers you to a urologist or andrologist. A first abnormal result is checked with a second sample, because sperm quality varies. All the reference values and ways to improve are explained in our article on the sperm test and male fertility.

Who to see in Morocco

The simplest entry point remains your gynaecologist, or your GP, who can start the work-up of both partners. Depending on the results, you will be referred to:

• a urologist or andrologist for the in-depth male work-up;
• an assisted reproduction centre, private or public, if insemination or IVF is being considered.

Since law 47-14 (dahir of 11 March 2019, Official Bulletin no. 6766), assisted reproduction can only be carried out in establishments approved by the administration, by practitioners who are themselves approved. Before committing, ask to see that approval. The law reserves assisted reproduction for married couples, both living, using their own gametes. The stages and questions to ask are in our piece on IVF in Morocco.

On reimbursement, an order published in the Official Bulletin of 24 December 2020 added certain classes of infertility medicines to the list of products reimbursed by AMO, according to EcoActu. The assisted reproduction procedures themselves have long been little or not covered. Check the rules in force in October 2026 with your fund (CNSS, CNOPS or private insurer) before starting. We publish no prices: they vary by centre and must be given to you in writing.

How to live through this waiting period

The work-up often takes a few weeks, paced by your cycles. In the meantime, nothing obliges you to answer the questions of the extended family or neighbours. Many couples choose to tell only one or two trusted people.

Infertility touches self-esteem, the couple, sometimes faith and the relationship with the in-laws. Our article living with infertility as a couple addresses these emotions and ways of being supported, including by a psychologist.