Consider referring a woman for specialist fertility assessment if she has not conceived after 1 year of regular unprotected vaginal intercourse without any known cause of infertility. This referral should include her partner for further clinical assessment and investigation.
Offer an earlier referral if the woman is aged 36 years or over, or if there is a known clinical cause of infertility or a history of predisposing factors for infertility.
Also consider earlier referral if the woman is using artificial insemination and has not conceived after 6 cycles of treatment, including her partner in the assessment if partner sperm is used.
In cases where treatment may result in infertility (e.g., cancer treatment), early referral to a fertility specialist is recommended.