Health encyclopaedia - Alphabetical Topic List

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Diagnosis of Infertility

If you’re young and healthy, there’s usually no need to see your GP until you’ve been trying for a baby for 18 months – two years. You should see your GP sooner if you’re over 35, because fertility decreases with age, and it can take quite a long time to find out what’s causing the problem. You should also see your GP sooner if you have or think you may have any of the problems described in the causes section.

When you see your GP, it’s important that you and your partner go together. This is because infertility can be caused by a male or female problem, or both. Your GP will discuss your general health with you; it’s important to tell them about any past illnesses. Your GP will also talk to you both about sex to check there are no difficulties there. Although you may find this embarrassing, it’s important to be honest, as the real problem can sometimes be difficulty with sex, which can be more easily overcome.

Your GP can examine both of you, and carry out some simple tests. Men have a sperm test to check the number and health of active sperm, and a urine test to check for chlamydia. Women have a blood test to check that ovulation (the monthly release of an egg) is happening, and also blood tests for rubella (German measles) and hormone problems. You’ll have a smear test if you’re not up-to-date, and a urine test for chlamydia.

The tests may reveal a problem that your GP is able to treat, or you may be referred to a specialist at your local hospital or fertility clinic for further tests. These may include:

Women:

  • Ultrasound scan to look at your womb and ovaries.
  • Follicle tracking –a series of ultrasound scans to follow the development of an egg in the ovaries. It also checks whether an egg is developing at all.
  • Hysterosalpingogram – this is an X-ray to check your Fallopian tubes.
  • A sample of cells may be taken from the lining of your womb to be looked at under a microscope.
  • Laparoscopy – a small cut is made in the lower abdomen and a thin, tubular microscope is used to look more closely at the womb, Fallopian tubes and ovaries. Sometimes dye is injected into the Fallopian tubes through the cervix (entrance to the womb) to show up blockages in the tubes as well.
  • Hysteroscopy – a small, thin tube with a camera on the end is used to look at the inside of the womb to check for problems such as fibroids or polyps.
  • Hysterosalpingo-contrast sonography (HyCoSy) – dye is inserted into the Fallopian tubes and an ultrasound scan shows up if there are any blockages. This is similar to the use of dye in laparoscopy, but gives a more detailed picture of the reproductive organs. The HyCoSy test can sometimes replace a laparoscopy, but it’s not suitable for everyone.

Men:

  • Semen analysis to check sperm numbers and quality.
  • Sperm antibody test to check for protein molecules that may stop sperm fertilising an egg.
  • Sperm invasion test – this checks whether sperm are swimming through the cervical mucus (the sticky fluid at the entrance to the womb)and are still active.