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 to 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.
The questions we ask
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, what stage they happened and what happened with these.
For men we need to know if you have had any children from previous relationships.
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 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 the 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 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.
Medical history and symptoms
The GP will discuss any medical conditions you have or had in the past, including Sexually transmitted diseases
If you’re a woman, we ask about your periods, any breakthrough bleeding and how painful they are.
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.
Several lifestyle factors can affect your fertility. The GP will want to know:
- if you smoke
- how much you weigh
- how much alcohol 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.
Physical examination for women
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
In many cases we will use an ultrasound scan
Physical examination for men
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.
Fertility tests for women
Tests to find out the cause of infertility in women include:
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.
This STI that can affect fertility. A swab – similar to a cotton bud, but smaller, soft and rounded – is used to collect some cells from your cervix to test for chlamydia. You will be prescribed antibiotics if you have chlamydia.
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.
Fertility tests for men
Tests to find out the cause of infertility in men include:
This is to check for problems with sperm, such as a low sperm count or sperm that are not moving properly.
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.