fertility assessment and treatment

Fertility Assessment and Treatment

Approximately 15 percent of couples will experience difficulty or a delay in falling pregnant.

There are many potential causes and a thorough assessment is the first step in determining what treatment, if any, is required to help you conceive.

It is recommended that you seek review with a Fertility Specialist if you have been trying for pregnancy for more than twelve months or if you have been trying for more than six months and are more than 35 years of age. This recognises that there is a natural decline in female fertility with increasing age.

If you or your partner have any known or suspected conditions which may affect fertility including: PCOS, endometriosis, previous abdominal or pelvic surgery, previous pelvic infection, mumps, testicular surgery or previous cancer treatment, an early review is recommended.

In some cases the cause of infertility will have a clear male or female cause. In a large proportion, the issue may be a mixed male and female cause and in some cases, the cause of infertility will be unexplained.

The important first steps involve a thorough history and examination and then some preliminary investigations. Investigations focus on preparing for pregnancy and determining the cause of delay in conceiving to allow us to make a plan for your treatment.

Fortunately, there are now many ways to assist couples in building their family. In many cases, assessment may provide the reassurance and support to continue to try to conceive naturally and no treatment is required. If however extra help is needed, this might include medications to induce ovulation, intrauterine insemination (IUI), in vitro fertilisation (IVF) and or intracytoplasmic sperm injection (ICSI).

Medications are given to induce ovulation when the problem is absent or infrequent ovulation. Intrauterine insemination may be used in conjunction with hormonal injections (COH + IUI)  to increase the chance of the egg and sperm meeting or where donor sperm is being utilised.

In IVF, hormonal medications are used to collect multiple eggs in one cycle. The eggs are then collected and fertilised in the laboratory to create embryos. The embryos are then grown in the lab and a single embryo replaced into the uterus. In some cases, it will be recommended that a single sperm be injected into the egg directly (ICSI) in order to fertilise the egg and create an embryo. The right treatment for you will depend on your individual medical history, results and preferences.