“Over 90 per cent of couples will become pregnant within a year of regular unprotected intercourse, so if it is taking you longer to conceive, we would recommend that you seek advice,” says Laura Carter-Penman, regional lead nurse at Bourn Hall.
Getting advice from a fertility specialist would involve an assessment of previous medical history and factors such as body weight, smoking, drinking, and drug use that can all influence the chances of getting pregnant.
At Bourn Hall this fertility nurse consultation is free and can identify where improvements to lifestyle such as weight loss or simple interventions such as medication to regulate ovulation can be used to boost the chances of natural conception.
Fertility testing may be advised to diagnose the cause of infertility.
What fertility tests can tell you
Common reasons why women struggle to become pregnant include:
Lack of eggs – a woman’s fertility starts decreasing from the age of 35 and more quickly for those over 40. Between the ages of 45 and 55 women stop releasing eggs altogether; if it happens before this age it is called an early menopause.
Test: A blood test called Anti-Mullerian Hormone (AMH) gives an indication of your egg store and your likely response to medication that is aimed at stimulating the ovaries to release eggs.
Failure to ovulate – Your ovaries may not be releasing eggs (ovulating) regularly. This affects one third of women and it is a common symptom of polycystic ovary syndrome (PCOS) caused by hormone imbalance. Symptoms may include irregular periods and weight gain, but many women have no symptoms.
Test: A simple blood test to check your progesterone hormone levels may indicate ovulatory disorders.
Damaged or blocked fallopian tubes – this affects about 15 in 100 women who haven’t been able to get pregnant.
Test: To check that your tubes are clear and there is no obstruction to an egg moving from the ovary to the womb, we use a HyCoSy ultrasound diagnostic test. A dye is injected into the tube and its progress followed on the ultrascan.
Fibroids or abnormality of the womb – large benign growths called fibroids or other abnormalities of the womb that may stop a fertilised egg from growing in the womb.
Test: a vaginal ultrasound scan can check the shape of your womb and any obstructions. To check for endometriosis a camera called a laproscope is used. (see the booth Painful periods? Endometriosis and fertility.)
What fertility tests can tell men
A semen test can show if you have one of these common reasons for failure to conceive:
- Too few sperm (low sperm count) or no sperm
- Abnormally shaped sperm, which are unable to move normally or fertilise an egg (poor morphology)
- Sperm that don’t swim well (poor motility)
Test: semen analysis. This is a thorough test performed by highly skilled embryologists and looks at shape, number and movement of the sperm and also other factors such as anti-bodies or white blood cells that might indicate an immune response or damage.
More about male infertility see our other booth “Low sperm count and male infertility”
Fertility diagnosis and treatment
Results from the testing would be reviewed by a hospital consultant if you have had tests at a hospital, or by a fertility consultant at Bourn Hall, if the NHS testing has been done through Bourn Hall or you have chosen to have a consultation with us.
Advice given on the next steps might include:-
If tests revealed irregular ovulation – then carefully monitored Ovulation Induction (OI) with fertility medication to boost egg production may be advised. This increase the chances of natural conception.
If tests reveal a lack of sperm or zero sperm or a varicocele – then further testing would be required to check the reasons for this and a minor operation, such as surgical sperm retrieval may be advised.
If tests reveal blocked tubes, endometrial tissue or ostructions such as a fibroid then surgery may be advised.
If the reason for infertility is inconclusive or can only be treated with assisted conception then onward referral for IVF may be advised.
Counselling – at Bourn Hall we offer support throughout your journey with us.
In the video below Regional Lead Nurse, Laura Carter-Penman talks about fertility consultations and fertility testing.