If you have been trying to conceive for six months or more without achieving a pregnancy, particularly if the female partner is entering her 30s, you should consider having a fertility assessment. Some situations may warrant even earlier assessment, for example:
- Female age of 35 or above
- No or irregular periods (after excluding pregnancy!)
- Previous abdominal or pelvic surgery in women
- Previous surgery to the reproductive system (apart from circumcision) in men
- Previous sexually transmitted disease (both men and women)
- Previous chemotherapy or radiotherapy (both men and women)
- Sexual dysfunction
Having an assessment does not mean that assisted conception or treatment is always necessary but it is best to catch any reversible cause early before female age becomes an additional factor.
During the initial consultation, both you and your partner’s medical history is reviewed and relevant factors discussed. This is usually followed by some preliminary investigations such as:
- Blood tests
- Vaginal ultrasound of the ovaries (particularly antral follicle count with respect to ovarian reserve) and the uterus
- Saline infusion sonohysterogram (SIS)/hysterosalpingo-contrast-sonography (HyCoSy) using modern ultrasound approach or hysterosalpingraphy (HSG) using conventional radiological approach to assess the uterine cavity and tubes (if indicated)
- Semen evaluation
We will then review these results and discuss with you on the most optimal treatment approaches (including further natural conception if appropriate) that best suit your needs and time frame.