Determining the cause of infertility
The investigations now available to a couple who have difficulty in achieving a pregnancy have greatly advanced over the past two decades. Whenever a couple think there is a problem in conceiving, they should seek the advice of their doctor (general practitioner or family doctor). Whenever possible couples who perceive problems in conceiving should be seen together as both partners are affected by decisions surrounding investigation and treatment of infertility.Your doctor will review your past medical and surgical events, especially any prior investigations or treatments for infertility, your current health status, including lifestyle and diet and any occupational risks. Your doctor will ask you about birth control, previous pregnancies and sexual practices within your current relationship. The history may reveal clues as to the underlying causes of your infertility so that the doctor can select the specific diagnostic tests that will identify your cause of infertility. The basic infertility workup typically takes a couple of months to complete. The stress of being tested and waiting for the results may add extra pressure to your emotions, your relationship with your partner and your sex life.
Some couples will only need assurance and advice about their general health and preconception care. While others will require referral to an infertility clinic where further investigations are usually carried out such as: laparoscopy and dye test, hysterosalpingogram, screening for chlamydia infection etc.
Factors that warrant early referral to specialist include:
- Woman's age is 35 years or older
- Absent or infrequent periods
- Previous abdominal or pelvic surgery such as ectopic pregnancy
- History of pelvic infection or a sexually transmitted disease.
- Presence of large fibroids
- If the man's semen analysis showed absent sperm or poor quality sperm
- Problem with sexual intercourse e.g. impotence.
- Undescended testicles
- Previous surgery such as hernia repair or hydrocele
- History of sexually transmitted disease
- Chemotherapy or radiotherapy