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Infertility and sub-fertility

Many couples plan on having a baby, and for most this happens within a reasonable amount of time. 85% of couples trying for a baby will get pregnant within a year.

Unfortunately, for 1 in 6 couples this is not easily achievable and they may need help to assess if there is a problem.

In fact, in most cases couples are not infertile but sub-fertile. In other words, they have the ability to conceive and have been unsuccessful so far. This could be corrected with appropriate advice or treatment.

The causes of infertility 

Conception is a process that depends upon many factors. The main factors are listed below:

  1. the production of healthy sperm by the man. Problems with this may include low sperm counts
  2. release of healthy eggs. Problems with this include irregular periods or polycystic ovarian syndrome or premature ovarian ageing (reduced reserve) and hormone imbalances
  3. normal fallopian tubes allow the sperm to reach the egg. Problems with blocked tubes could be due to infection such as chlamydia, adhesions, endometriosis or complications of previous surgery
  4. implantation of an embryo in the woman's uterus (womb). Problems with this include fibroids and polyps, or scarring (Asherman's syndrome)
  5. the presence of endometriosis which could cause scarring of tubes and can be associated with pelvic pain

In some cases, even after a full range of tests, no cause is found. This is called unexplained infertility and is more common when older. Fortunately, there are several treatment options available for this.

How we asses infertility 

We advise you seek medical help if you are unable to achieve pregnancy within a year of unprotected intercourse. If there is a known problem such as irregular or absent periods, pelvic issues, sexually transmitted infections (PID), endometriosis, or male, sperm and testicular problems, seek help sooner.

We will carry out  tests to help identify any problems and advise you on how to improve your chances of conception, or what treatment is best.

The main areas of assessment are:

  • testing ovulation and ovarian reserve
  • a sperm test
  • an ultrasound scan
  • tests of Fallopian tubes, if required

The next steps

If we identify a problem, we'll discuss this with you in detail and suggest the next steps. We offer a wide range of fertility treatments, which can significantly improve your prospects of conceiving.

Some of the ways we can aid conception include:

  • ovulation induction
  • Intrauterine Insemination Treatment (IUI)
  • In-Vitro Fertilisation (IVF)
  • Intra Cytoplasmic Sperm Injection (ICSI)
  • egg and sperm donation

The factors that determine your treatment 

This will depend on your personal circumstances including symptoms, past history, results of tests, and:

  • the severity of your condition as determined by test results
  • how long you've been trying for a baby
  • any infertility treatment you may have had in the past
  • the benefits of assisted methods of conception treatment, for example IUI, IVF or ICSI
  • and most importantly, your wishes

Accessing support

The following organisations offer support:

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