The Timing to seek treatment for infertility depends on you and your partner, your age and any known risk factors that may affect your fertility. For e.g if you are relatively healthy and your age is less than 35 years old, you could wait for one year. However, if you have a known risk factors such as medical illness, irregular menses, history of pelvic infection or age more than 35 years old, do seek help after 6 months. It better to seek help earlier as the longer you wait the older you get and this will affect the quality of your eggs. It is better for both you and your partner to see your doctor together as sometimes the problem may affect both of you. Hence, discussion of the treatment will require both of you to be present.
Who shall I seek treatment from?
It is best you talk to your family doctor regarding your infertility problem who could do the basic investigations for infertility. Pending on the results of the investigation, she or he may then refer you to a gynaecologist specialising in infertility.
How will I know the cause for my infertility?
In order to know what is the cause for your infertility you and your husband need to undergo several basic investigations for infertility. For conception to occur the woman should be ovulating, has no blockage in her tubes and no uterine abnormalities that could interfere with implantation. In addition, the husband must produce sperm sufficient in number, quality and motility.
What are the basic infertility investigations?
For female:
a) Hormone levels (including FSH, LH and Day 21 progesterone level to confirm that you are ovulating) This is a blood test.
b) Assess tubal patency. This could be done either via:
i)Hysterosalpingogram (HSG) which is a x-ray done of your uterus and tube after a dye is injected through your cervix
ii)Laparoscopy and dye test. This is an operation requiring general anaesthetic. The doctor will make one small incision at your belly button and another one above your pubic bone. This operation would allow the doctor to inspect your pelvis, uterus, tubes and ovaries for any abnormalities. In addition, the dye test could be done in the same setting to check the patency of your tubes.
c) Pelvic ultrasound. This could assess the uterus, ovaries and tubes. However, it could not detect the presence of pelvic adhesions (scar tissue) and small endometriotic spots.
For male:
a) Semen analysis. Your husband will be required to give a sample of his sperm which will be sent to the lab. The number, quality and motility of your husband’s sperm will be assessed. If there is a problem further referral to a specialist will be required.
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