I am going to say something that may surprise you. Something that goes against what most people — including many medical professionals — will tell you.
Do not wait six months before seeking fertility help. Do not wait one year. In fact — do not wait until you are trying to conceive at all.
In my years of working with couples on their fertility journeys, I have come to a firm and unwavering belief: fertility testing should be done before you go to the altar. Before the wedding. Before the marriage. Before the trying begins.
I know this challenges tradition. I know it challenges what doctors advise. I know it challenges what society considers normal. But I have seen too much — too many couples who spent years trying, too many women who suffered silently, too many marriages strained beyond repair by fertility challenges that could have been identified and addressed long before they became a crisis — to stay silent about this.
Where the Standard Advice Falls Short
The standard medical guidance is this: if you are under 35, try to conceive for 12 months before seeking help. If you are over 35, try for 6 months.
This advice is not malicious. It is based on the understanding that many couples will conceive naturally within these timeframes and do not need medical intervention. But it has a serious flaw.
It assumes that trying and failing is the only way to discover that there is a problem. It treats fertility challenges as something to be revealed by months of disappointment rather than something to be assessed proactively before disappointment begins.
And for the couples who do have underlying fertility conditions — the waiting is not neutral. It is months and sometimes years of a condition progressing, of egg quality declining, of emotional weight accumulating, of financial pressure building — all while the problem that needed addressing from the beginning sits unidentified and untreated. (We explore this fully in The Most Expensive Decision You Can Make — Waiting.)
Six months of waiting when you have blocked tubes does not bring you closer to a baby. It brings you six months further from one. Twelve months of waiting when your husband has a sperm count issue does not increase your chances. It decreases them.
The Case for Pre-Marital Fertility Testing
I want to make a clear and direct case for why couples should know their fertility status before marriage — not as a condition of marriage, but as an act of wisdom, love, and preparation.
Fertility treatment is expensive. This is the reality that nobody talks about honestly enough. Herbal fertility programmes, medical investigations, IUI, IVF — these cost significant amounts of money. Money that, when spent in a crisis — after years of trying with no preparation — creates enormous financial strain on top of already significant emotional strain. If a couple knows before marriage that one or both partners have a fertility condition, they can plan. They can save. They can seek treatment early — when conditions are typically more manageable and less expensive to address. Knowledge before the wedding is a financial protection. Ignorance is an expensive gamble.
Conditions are more treatable when found early. Endometriosis at 24 is a different medical reality than endometriosis at 34. A small fibroid at 26 is a different situation than multiple large fibroids at 36. A hormonal imbalance identified at 28 can be addressed before it has had years to compound and damage the reproductive environment. The earlier a condition is found, the more treatment options are available, the less invasive those options typically need to be, and the better the outcomes.
It protects both partners. Fertility is not a woman’s issue. As I have said many times — male factor infertility contributes to approximately 40 to 50 percent of all cases where couples struggle to conceive. A man who has a low sperm count or poor motility has no idea — because there are no symptoms. He looks healthy. He feels healthy. Pre-marital fertility testing for both partners removes this uncertainty. It gives both people the information they need to walk into marriage — and into trying to conceive — with full awareness and a plan if one is needed.
It reduces the emotional trauma of infertility. The discovery of a fertility challenge after marriage — after months or years of trying, after hope has been built and then repeatedly disappointed — is one of the most devastating experiences a couple can go through. When a couple enters marriage knowing their fertility status, they are not surprised by a challenge. They are prepared for it. Preparation does not remove the difficulty of a fertility challenge. But it removes the shock — and the shock is often what causes the most damage.
What Pre-Marital Fertility Testing Should Include
For a complete picture, see You Are Not Infertile — You May Just Be Uninformed, which covers each of these tests in detail.
For women
- Full hormonal profile — FSH, LH, AMH, oestrogen, progesterone, prolactin, thyroid function
- Pelvic ultrasound — assessing the uterus, ovaries, and looking for fibroids, cysts, or structural concerns
- Assessment of ovarian reserve through AMH — giving an indication of egg quantity
- Infection screening — ruling out any silent reproductive tract infections
For men
- Semen analysis — assessing sperm count, motility, and morphology
- Hormonal assessment if indicated — testosterone, FSH, LH
- Infection screening
Neither of these is invasive. Neither requires significant time. And both together give a couple a complete picture of their reproductive health before they begin their life together.
This Is Not About Fear — It Is About Wisdom
I want to be clear about what I am not saying. I am not saying that a fertility challenge should prevent a marriage. I am not saying that people should only marry those with perfect fertility. I am not saying that love should be conditional on test results.
What I am saying is that informed love is stronger than uninformed love.
A couple who knows that one partner has PCOS, or that sperm count is low, or that there is a hormonal imbalance that needs addressing — and who chooses to walk into marriage together with that knowledge and a plan — is a couple that is prepared. United. Facing the challenge together from the very beginning rather than discovering it alone in the middle of a crisis.
Knowledge is not a threat to love. Ignorance is.
A Message to the Young Women and Men Reading This
If you are not yet married — or if you are recently married and have not yet begun trying — please hear this.
Do not wait for six months of failure to tell you what a simple test could reveal today. Do not let financial barriers stop you — a basic fertility assessment is far less expensive than months or years of fertility treatment that could have been avoided or significantly shortened with earlier knowledge. Do not let cultural embarrassment stop you — your future, your health, and your family deserve the protection that information provides.
Ask your partner to test with you. Make it a shared act of love and preparation. Go together. Know together. Plan together.
At Ohemaa Fertile Home
We welcome couples at every stage — before trying, during trying, after years of trying. We do not judge the stage you are at. We meet you where you are.
But if you are reading this before you begin your journey — before the wedding, before the trying, before the waiting — please use this moment. Come to us. Let us help you understand your fertility picture before it becomes a crisis.
You do not have to wait to suffer before you seek help. Come before the storm. Come while you still have the most time, the most options, and the most hope. We are here. 🌿
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At Ohemaa Fertile Home, we provide guided herbal fertility support rooted in three generations of traditional knowledge. We serve women across Ghana, Nigeria, and the diaspora. Reach out to us on WhatsApp for a free, confidential consultation.
