Trying for a baby should be a joyful experience. So when you do not fall pregnant quite as quickly as you had hoped, the whole experience can become fraught with anxiety and you’re first thought can be fertility problems.
The first thing you should be aware of is that you are not alone. It takes some 10% of normal, healthy, fertile couples more than a year to achieve a pregnancy just by chance. So, if you and your partner have been trying for less than 12 months, it may simply be that you have not been trying long enough. As a result, you would not normally need a referral to see us for an infertility investigation, unless there is a special and obvious reason why you have not become pregnant.
To achieve a pregnancy, you must have the right number of sperm in the right place at the right time in a woman who is ovulating and who has patent (open) fallopian tubes.
Causes of infertility
If you are unlucky enough to experience a delay in falling pregnant, then we can explore each aspect of this problem, try to formulate a diagnosis and understand the underlying cause. It is often helpful to meet with both partners and a careful history will be taken, concerning a number of background factors.
Of obvious importance are the nature and regularity of the female partner’s menstrual cycle, as this can give a clue as to whether ovulation is happening correctly. A number of other key questions are required to check for the possibility of underlying medical or surgical problems, which could be getting in the way of fertility.
Looking at you and your partner
It is usual, at an early stage, to send a sperm sample for analysis because, even in very healthy, normal men with normal sexual function, there can sometimes be a problem with the number or quality of the sperm produced. Sperm test results can vary from time to time, so occasionally these tests need to be repeated to get a clear picture of what is going on.
From the female point of view, a pelvic examination is required and usually an ultrasound scan will be offered. Some blood tests will be recommended to check your hormone status and also to check for evidence of ovulation.
Treating fertility problems
At this stage, there may be an obvious clue as to the cause of the problem and this can be specifically investigated. For example, patients with pelvic pain or who are known to have endometriosis may be offered a laparoscopy to treat the condition and improve the chances of pregnancy, as well as improving pain symptoms. Patients with polycystic ovary syndrome may need special advice, concerning medical treatment to improve ovulation, and sometimes laparoscopic surgery to treat the ovaries directly. Patients who are not ovulating clearly need help in that regard and this is usually in the form of tablets initially, although sometimes treatments with injections need to be arranged. It may be necessary to check that the fallopian tubes are patent (open) and this can sometimes be done via an x-ray test with an internal examination and sometimes via a laparoscopy.
Further help should you need it
Some patients will need special treatment to try and achieve pregnancy and we have close links with specialist IVF clinics, both nearby and further afield, if on-going referral is found to be necessary.
Fertility problems can be one of the most rewarding areas of gynaecological treatment and nothing gives us more pleasure than to have been able to assist a couple to achieve their desired pregnancy with the best possible treatment.