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This varies a little bit based on age. For women under 35, if you have been trying to conceive for a year and have not become pregnant, then I advise seeking help. Usually around 80-90% of women under the age of 35 can conceive within a year of trying.

If you are over 35 years of age and have not fallen pregnant within 6 months then I strongly recommend speaking to a specialist.

I have a 6 point plan that I recommend to help tackle any fertility delays you may be experiencing which includes:

  1. Sex
  2. Sperm
  3. Receptive Uterus
  4. Ovulation
  5. Open Tubes
  6. Patience

You can hear the ins and out of my SSROOP plan here.

Some other reasons that you may wish to speak to a specialist earlier that 6 or 12 months are:

  • Your menstrual cycles are either irregular or absent
  • You have painful periods
  • You have a known history of fertility problems
  • You have a history of pelvic inflammatory disease or endometriosis
  • You have had multiple miscarriages
  • You have been recently diagnosed or treated for cancer with drugs and radiation
  • You wish to freeze your eggs and store them for the future


Is IVF the next step?

There are many reasons to consider IVF but it is not always the next step. There are options that can be tried before IVF including ovulation induction or intra uterine insemination. Before any decisions are made you need to speak to a fertility specialist. Investigations and relevant tests will be undertaken to get a better idea of what is happening and what is best next steps for you.

 

What causes infertility?

There are many reasons why a person may be infertile. For some people infertility is congenital – they are born with it.

For males – the most common causes are:

  • Problems with sperm (including low sperm count)
    • No sperm cells are produced – Azoospermia
    • Few sperm cells are produced – Oligospermia
    • A high proportion of sperm is abnormally shaped – Teratospermia
  • Obstructions to the passage of sperm
  • Functional problems – including difficulty with ejaculation, reduced sexual desire, and difficulty maintaining an erection.
  • Hormonal problems

In women there are many different causes of infertility including:

  • Problems with ovulation including polycystic ovarian syndrome where the ovaries secrete excessive amounts of male hormone testosterone.
  • Damaged fallopian tubes – which may prevent the eggs travelling from the ovaries to the uterus and in turn affect the fertilisation of the egg by the sperm..
  • Abnormalities of the cervix and uterus
  • Premature menopause which is defined when menstruation stops before the age of 40.
  • Diabetes
  • Endometriosis,
  • Thyroid disorders
  • Kidney disease
  • Certain medications have been known to cause temporary infertility

 

Diagnoses

For males we will complete a semen analysis so we can check the number, shape and movement of sperm. The samples will be sent to a laboratory and checked for abnormalities and the presence of antibodies.

In the event that abnormalities in the semen analysis, we may require blood tests to help us assess hormone levels too, which will assist in the final diagnosis.

 

For females there are several tests that we may do including:

  • Blood tests
    • To measure your hormone levels
    • To determine ovulation
  • Biopsies to evaluate the inner lining of the uterus.
  • Ovarian reserve testing which can determine the number and quality of eggs ready for ovulation.
  • Imaging studies such as a pelvic ultrasound to obtain a detailed view of your fallopian tubes and uterus.
  • Fallopian x-rays which can identify any blockages in your fallopian tubes.
  • Laparoscopic evaluation involves inserting a thin tube fitted with a camera through an incision in your abdomen, in order to detect any abnormalities in your reproductive organs, such as the ovaries, uterus, and fallopian tubes.

 

Are you concerned?

If for any reason you are worried about your fertility – if you have been trying to get pregnant and have not yet been successful it may be time for you to reach out. Firstly talk to your GP.

Do not worry – there is plenty of help and many options. The good news is about two-thirds of the couples treated for infertility conceive successfully.

 

 

 

 

 

 

 

Dr Joseph Sgroi an infertility, IVF, Obstetrician, gynaecologist and women’s health expert who provides holistic medical care to his patients. He specialises in all aspects of women’s health, pregnancy care and fertility (both male and female infertility) and IVF.