If you have been trying unsuccessfully for a baby for over a year, or 6 months if you are over 35 you should consider consulting your doctor. He/she will question you about your menstrual history and the length of time that you have been trying to conceive. Your doctor will also need to know all about you and your family’s medical history. It is important that you answer all questions honestly to enable your doctor to make a detailed assessment of the situation.
Most G.P.’s, will only give you both a physical examination to check your reproductive organs and general health, after a year of regular sexual intercourse without contraception.
If after the physical examination your doctor suspects that either you or your partner have fertility problems, a further series of tests will be conducted to see what treatment you may need.
These tests may include:
- Semen analysis – doctors can determine by checking a semen specimen if your partner has a low sperm count or any sperm abnormalities. To enable the G.P. to conduct this investigation your partner will have to produce a specimen. The sample can be taken at home but will need to be delivered to the laboratory within 1 hour. We have a male fertility test available on this website, which can determine male fertility potential from the privacy of your home.
- Ovulation tests – home ovulation tests measure the changing levels of hormones in your body, therefore helping you to work out the best time for sexual intercourse.
- Hormone tests – G.P.’s will take regular blood tests to measure your hormone levels. This method can help determine reasons for possible ovulation failure in women and problems with sperm production in men.
- Post – coital test – during your fertile time an appointment should be made with your doctor. He/ she will ask you to have sexual intercourse several hours ‘before’ the visit. During your appointment the doctor will remove some of your cervical mucus for examination. Under a microscope he/she will be able to detect the presence of active sperm.
- Surgical treatments – a laparoscopy is an abdominal operation used to help locate the source of fertility problems. A laparoscopy can detect tubal damage and endometriosis as well as other problems.
- Ultrasound – this can check that your eggs are developing as they should and also check whether you are ovulating. An ultrasound in a man can show whether the sperm are being stored and passed as they should.
The treatment you require will depend on the results of the investigations your doctor has made. The ability to help sub-fertile and infertile couples conceive has greatly improved over the past 25 years. However, some of the sophisticated techniques may be limited to a few specialist centres and you may have to pay for private treatment. What is available to you on the N.H.S. depends on where you live. One of the main advantages of private treatment is that you can avoid the N.H.S. waiting list, however, private treatment can be very expensive.
Possible treatments may include:
- Drug treatments – if test results detect problems with ovulation, fertility drugs may be used. These drugs can be used to encourage and regulate ovulation. Because the drugs stimulate the ovaries a woman can produce and mature one or more ova in each cycle. In men, fertility drugs can help increase sperm production.
- In Vitro Fertilisation (I.V.F.) – if the fallopian tubes are damaged and can’t be repaired or there is a problem with sperm transportation, I.V.F may be recommended. This involves fertilisation of the egg taking place outside the body (in a laboratory) followed by implantation into the woman’s uterus (womb). In vitro means ‘in glass’ and refers to the dish where fertilisation takes place. The process of I.V.F. treatment is commonly known as a ‘test tube baby’.
- Artificial Insemination (A.I.) – sometimes when couples are producing sperm and eggs, but have a problem bringing them together, (maybe due to the woman’s tubes being blocked or even a problem with intercourse) artificial insemination is sometimes used. In this situation, the sperm and eggs are physically placed together in the woman’s womb and then left for nature to run its course.
- Surgery – if a woman’s fallopian tubes are blocked she will be offered surgery to unblock them. If the surgery is a success the couple may then be able to go on and have a natural conception. If the man’s sperm ducts are blocked and it’s interfering with sperm production or movement, he will also be offered surgery. If endometriosis is the cause then surgery to remove the cysts may be carried out.
- Gamete Intra-Fallopian Transfer (G.I.F.T.) – this is similar to I.V.F. in that the women’s eggs and the man’s sperm are collected (doners can also be used) and mixed together in a dish. The difference between G.I.F.T. and I.V.F. is that the gametes (eggs and sperm) are transferred to the woman’s fallopian tubes, so that fertilisation takes place inside the body not outside.
- Zygote Intra-Fallopian Transfer (Z.I.F.T.) – a combination of I.V.F. AND G.I.F.T. The newly fertilised egg (known as a zygote) is fertilised outside the body as with I.V.F. but is then transferred to the woman’s fallopian tubes sooner than it would be with I.V.F..
- Intracytoplasmic Sperm Injection (I.C.S.I.) – this treatment is ideal for couples where the man has a low sperm count or produces low quality sperm. Only one sperm is required and this sperm is injected directly into the centre of the egg.
Where couples do not produce either sperm or eggs, the only possible treatment is to use donated eggs or sperm.
Some of these treatments will depend on what is on offer in your area and what you are eligible for. Your financial situation may play an important factor as private treatment can be very expensive. Before going ahead with any treatment you should find out what that particular treatment involves and what the success rate is. Your doctor will help and advise you on which treatment is best for you.