Diagnosing Infertility
At this first consultation, we will need to ask some questions to understand what the issues are for you.
It can be strange talking to someone about this sort of thing, but we are sensitive and caring about your feelings. We know the problems surrounding your concerns. We try and guide you through the questions. We think it helps to know what sort of things we will ask, so you can perhaps get information together or think about your answers.
It can be strange talking to someone about this sort of thing, but we are sensitive and caring about your feelings. We know the problems surrounding your concerns. We try and guide you through the questions. We think it helps to know what sort of things we will ask, so you can perhaps get information together or think about your answers.
Initial Consultation the questions we will ask
Medical history and symptoms
We will discuss any medical conditions you have or had in the past, including sexually transmitted diseases
For women, we will ask about your periods, any breakthrough bleeding and how painful they are.
Medicine
We ask you about any medicine you’re taking and might discuss alternative treatments with you, as some types of medication affect fertility. You should mention any non-prescription medicine you’re taking, including herbal remedies and supplements. Make a note of them to bring along.
Lifestyle
Several lifestyle factors can affect your fertility. We will need to know:
- If you smoke
- How much you weigh
- How much alcohol do you drink
- Whether you take any illegal drugs
- If you’re stressed
We may recommend making changes to your lifestyle to increase your chances of conceiving.
Sex
You’ll be asked when and how often you have sex and whether you have any difficulties during sex, perhaps if it’s painful or if there are any issues with ejaculation. We will ask if you have been tracking your ovulation.
You may feel uncomfortable or embarrassed discussing your sex life with us, but it’s best to be open and honest. If the fertility problem is related to sexual issues, it may be overcome easily.
Length of time trying to conceive
We will ask how long you’ve been trying to conceive, and what you have tried in order to try and increase the chances of pregnancy. This helps us to understand what to do to help.
About 84% of people will conceive within 1 year if they have regular unprotected sex (every 2 to 3 days). Of those who do not conceive in the first year, about half will conceive in the second year.
If you’re under 40 and have not been trying for a baby for very long, you may be advised to keep trying for a little longer.
Previous pregnancies and children
For women, we need to know about any children you have had and a little about the pregnancies. We also need to know about any miscarriages, at what stage they happened and what happened with these.
For men, we need to know if you have had any children from previous relationships.
Length of time since stopping contraception
You’ll be asked about the type of contraception you have used and when you stopped using it. It can sometimes take a while for some types of contraception to stop working and this may be affecting your fertility.
Treatments and Investigations for women
Physical examinations
We will weigh you to see if you have a healthy BMI.
Examine your pelvic area to check for infection, lumps or tenderness, which could be a sign of other issues.
Blood tests
Samples of your blood can be tested for a hormone called progesterone to check whether you’re ovulating.
The timing of the test is based on how regular your monthly periods are.
If you have irregular periods, you’ll be offered a test to measure hormones called gonadotrophins, which stimulate the ovaries to produce eggs.
Chlamydia test
This STI can affect fertility. A swab – similar to a cotton bud, but smaller, softer and rounded – is used to collect some cells from your cervix to test for chlamydia. You will be prescribed antibiotics if you have chlamydia.
Ultrasound scan
An ultrasound scan can be used to check your ovaries, womb (uterus) and fallopian tubes. Certain conditions that can affect the womb, such as endometriosis and fibroids, can prevent pregnancy.
A scan can also be used to look for signs that your fallopian tubes (the tubes that connect the ovaries and the womb) may be blocked, which may be stopping eggs from travelling along the tubes and into the womb.
If the ultrasound suggests a possible blockage, we will discuss further checks.
Transvaginal ultrasound scan.
During a transvaginal ultrasound scan, an ultrasound probe is placed in your vagina. The scan can be used to check the health of your womb and ovaries, and for any blockages in your fallopian tubes.
Treatments and Investigations for men
Physical examinations.
A physical examination will help to identify lumps or deformities in the testicles and to check the penis to look at its shape, structure and any obvious abnormalities.
Sperm Analysis.
This analysis is to check for problems with sperm, such as a low sperm count or sperm that are not moving properly.
Chlamydia test.
A sample of your urine will be tested to check for chlamydia, as it can affect fertility. If this is positive, you will be prescribed antibiotics.