There are few things as distressing, heart breaking and lonely as failing to fall pregnant, month after long month. Well-meaning pressure from friends and family often makes the heartache and guilt worse.

And yet infertility is remarkably common – as many as one in seven couples experience fertility troubles at some stage, says acclaimed Cape Town fertility specialist Dr Sulaiman Heylen, of the Cape Fertility Clinic. And in many cases there is a medical reason for the infertility and a way to fix it.

The good news is that for the majority of infertile couples there is light and the pitter patter of little feet, at the end of the tunnel.

What is infertility?
If you've been having unprotected sex for 12 or more months without falling pregnant, you are considered to be infertile. If you are over 35 years of age, this time period drops to six months.

This doesn't mean there's definitely a problem. What this does mean is that it is time to see a fertility specialist who can work out what the problem is, and if there is a straightforward cure. Remember even fertile people have only a 25% chance of falling pregnant in any one month.

I haven't fallen pregnant yet, so now what?
After years of trying to fall pregnant naturally, it is time to let an expert check that both you and your partner are in good working order.

They will take a detailed history from both partners and a medical examination which might include blood tests (to measure your hormone levels), an ultrasound to check on the state or status of your uterus and ovaries, and an analysis of your partner's semen.

In 95% of infertility cases, one of the following are behind your difficulties in falling pregnant: