By Dr Andrew Davidson, Medical Director of City Fertility Centre Gold Coast and Sydney.
You are keen to have a baby but you haven’t fallen pregnant yet, so when is the best time to seek extra help and advice?
Well, at City Fertility Centre our rule of thumb is that if you have been trying to fall pregnant without success after 12 months of unprotected intercourse, or six months if you are over 35, you should seek medical advice from your GP or a specialist.
Other instances where you might want to seek fertility advice early on include the unexpected arrival of menopause, polycystic ovaries, irregular or non-existent menstruation, when either you are or your partner is a current or past oncology patient, or when the male partner has had a vasectomy.
Why have a Fertility Check?
The reality is that infertility affects both men and women. Male-factor infertility accounts for 30 per cent of cases, female-factor infertility is responsible for 30 per cent of cases, and both male and female factors are the cause of 30 per cent of cases of infertility. About 10 per cent of infertility problems remain unexplained even after complete medical evaluations.
While infertility can be a challenging experience for you and your partner, the good news is that often it can be treated. A number of infertility medical conditions can be treated with assisted reproductive technology (ART).
Common Causes of Infertility Include:
- Medical conditions: Certain conditions affecting women can hinder a couple’s attempts to conceive. These include Polycystic Ovarian Syndrome (PCOS), endometriosis, blocked fallopian tubes, premature menopause, insulin resistance, thyroid disorders, and genetic conditions.
- Sperm quality: Sperm motility (swimming ability), morphology (shape), count and vitality (ability to live) can affect a couple’s likelihood of falling pregnant. Many factors can affect male fertility, including sexually transmitted infection, zinc deficiency, smoking, alcohol, recreational drug use, excessive heat, constant exposure to toxic substances, and genetic conditions.
- Age: Once a woman reaches the age of 35, her fertility begins to decline.
- Irregular menstrual cycles: Irregular cycles may suggest a problem with ovulation.
What Fertility Tests are There?
Fertility Tests for Women
- Blood tests to identify common causes of ovulation dysfunction are undertaken to check levels of estrogen, luteinising hormone (LH), follicle-stimulating hormone (FSH) and thyroid-stimulating hormone (TSH). This blood test is normally performed in the first week of your menstrual cycle.
- Blood tests and transvaginal scans to assess ovarian reserve: an anti-Mullerian hormone (AMH) blood test can be performed in conjunction with other blood tests and transvaginal scans to predict ovarian reserve. AMH is a hormone produced by small follicles in the ovary that contain eggs. The amount of AMH gives an indication of the number of eggs being produced, or ovarian reserve.
- Pelvic ultrasound or X-ray to check fallopian tubes and uterus: this can also check for blockages and ovarian cysts, and determine whether there are any physical changes, such as fibroids or polyps, that may affect your menstrual cycle.
Fertility Tests for Men
- Semen assessment to evaluate the amount and quality of semen and sperm. This is sometimes called a sperm count and tests motility (movement), morphology (shape), count and vitality (ability to live and endure) of sperm.
- Blood test to examine hormone levels: assesses FSH, LH and testosterone.
- Other tests: depending on the results of the initial tests, your treating doctor may require a sperm DNA fragmentation test, an immunobead check or a testicular biopsy. For more information about these tests, visit our page Sperm Test and Semen Assessment.
Who can Carry out the Fertility Tests?
You can start the process of having fertility tests with your GP, a gynaecologist or a dedicated fertility specialist.
At City Fertility Centre, our specialists offer expertise in treating even the most difficult and resistant cases of infertility.
Please note that you will require a referral from your GP to see a specialist. A current referral is required to claim the cost of specialist treatment back through Medicare. Download a Referral Form here.
For further information, please visit our page Trouble Falling Pregnant?
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