When to see a Fertility Specialist

A few of the more common medical conditions that can sometimes have an impact on conception include Polycystic Ovarian Syndrome (PCOS), Endometriosis, fibroids, blocked fallopian tubes and premature menopause.

•  Polycystic Ovarian Syndrome (PCOS): This is a condition where the ovaries secrete abnormally high amounts of androgens (male hormones), which often cause problems with ovulation.
• Endometriosis: Endometriosis results when endometrial-like cells (cells from inside the uterus) grow outside the uterus. Distortion of the anatomy due to endometriosis can block or change the function of the fallopian tubes and prevent the sperm from reaching and fertilising the egg.
•  Fibroids: These non-cancerous masses are found in the uterus or cervix. Uterine fibroids are found in one out of every four or five women in their 30s and 40s. Fibroids can cause tubal blockages, prevent the embryo from attaching to the uterine wall and cause miscarriage. The impact the fibroids have on fertility depends upon their size and location.
•  Blocked fallopian tubes: When fallopian tubes are blocked, the egg can be prevented from meeting the sperm.
• Premature menopause: Premature Ovarian Failure (POF) is also called early menopause and refers to a condition where the ovary stops ovulating earlier than is normal. The average age range for menopause is between 45 and 55.
• Other medical causes: Thyroid disorders and genetic conditions.

Irregular cycles may suggest a problem with ovulation and can impact on your ability to conceive. The average length of the menstrual cycle is 28 days, but can range between 25 and 35 days. The menstrual cycle is determined by a complex interaction of hormones, so any hormone imbalance can make your period irregular. Although, in most cases, irregular cycles are not dangerous, it is important to determine what is causing the irregularity sooner rather than later.

Fertility advice should be sought if any of the following sperm issues are known: poor sperm morphology (abnormally shaped); poor motility (slow-moving); low sperm count; the presence of antisperm antibodies; ejaculatory problems or azoospermia (no sperm present); or vasectomy.

You should seek help if you are under 35 years of age and have not fallen pregnant within 12 months of unprotected intercourse, or if you are over 35 and have not fallen pregnant within six months of trying. For women aged 40 and over, I recommend further investigations be initiated after three months of trying to fall pregnant, as female age is one of the most important predictors of whether pregnancy will be achieved.

If there is a history of a genetic condition in the family that can be passed down through the genes and it is concerning you, then it is wise to seek advice from a fertility specialist. There are now several methods of genetic testing in IVF known as Pre-implantation Genetic Diagnosis (PGD) to screen for anomalies before fertilisation or implantation occurs.

After three or more miscarriages (known as recurring miscarriages), tests are commonly carried out to look for the cause. People experiencing recurrent miscarriage are often in a difficult situation as they are successfully conceiving which is positive, then hopes are dashed when the pregnancy fails. There are some common reasons for miscarriages and a fertility specialist will work with you to try and determine and rectify this.

If you know you will require the help of a sperm or egg donor, then it is wise to seek the help of an experienced fertility specialist. A fertility specialist will be able to discuss and guide you through the process, helping you make informed decisions and find the right option for you.

If you are concerned about preserving your fertility due to medical, lifestyle or other factors then it is wise to meet with a fertility specialist to discuss the pros and cons and options available to you. While freezing sperm, eggs and embryos is now common practice, it can never guarantee a future pregnancy, but it can increase the odds.