Medically speaking, a couple is said to be having fertility difficulties when they have had regular unprotected sex for 12 months without achieving a pregnancy or they have 3 or more consecutive miscarriages. Up to 15% of all couples fit this definition. The aim of investigating couples experiencing fertility difficulties is to identify potentially treatable infertility causes (diagnosis), and to identify their chances of achieving a pregnancy without further assistance (prognosis). While infertility is classified into “causes affecting women” and “causes affecting men,” the reality is that there is often a bit of both that compounds the situation. Almost 20% of the time, no clear reason is found at all. This is called unexplained or idiopathic infertility.
Common Infertility Causes Are:
- Ovulation (egg production) disorders, causing complete absence of or reduced production of eggs e.g.
- Polycystic Ovary Syndrome
- Premature menopause
- Tubal disorders – blockage or absence of one of both fallopian tubes e.g. pelvic infection, scarring from surgery
- Abnormal semen test – low or no sperm, inactive sperm, abnormal shaped sperm, the presence of sperm antibodies or any combination of these
- Other factors such as age, genetic disorders and endometriosis can also have an impact on the chance of pregnancy.
Making A Diagnosis
- Testing for egg production – this might involve keeping a temperature chart, hormone urine or blood testing and ultrasound scans, depending on the individual situation.
- Testing the Fallopian tubes for blockage – which can be done either using an X-ray called a hysterosalpingogram (or HSG), HyCOSY or surgery called a laparoscopy (Key Hole Surgery).
- A semen analysis – Fertility Solutions policy is to have a semen analysis report current within 12 months that has been performed at an accredited fertility clinic – after all we want to make sure that the semen sample is suitable for the treatment it will be used for.
Sometimes the cause of a couple’s infertility is so obvious that no testing is needed (e.g. the man has had a vasectomy or the woman her tubes tied), but for most couples it isn’t that clear cut. Once an issue(s) has been identified, more tests may be required to determine the precise infertility cause and whether it will respond to treatment.
Disorders of egg production can often be treated with a variety of medications that stimulate the ovaries to produce eggs and others that initiate ovulation. This type of treatment is known as ovulation induction or OI.
Insemination with partner or donor sperm can be a treatment option (in combination with OI or on its own) as long as the fallopian tubes are open (patent) and if the sperm quality is of a suitable quality to be used for insemination. This type of treatment is often referred to as artificial insemination (AI), intra uterine insemination (IUI) of donor insemination (DI).
In Vitro Fertilisation (IVF) is another treatment option for some and can be used as a treatment for most causes of infertility provided we can get an egg, some sperm and there is a uterus. However, depending on the cause(s) of infertility, there can be other treatments that might also be successful. Surgery might be an option for some forms of fallopian tube problems.
If you aren’t clear about why fertility treatment may be the best option for you and your partner at this present point in time, we encourage you to discuss your specific situation with your fertility nurse or specialist. We offer a free private one-on-one consultation, so you can understand all of your options.