So you’ve had your tests, what can you expect from the results?
It’s not uncommon to have issues when trying to conceive. Some of the investigations may help identify the cause of any fertility issues, as it could be down to many different things. However in some cases, the cause can not be identified.
Female factor infertility
One of the most common reasons for fertility issues in women is caused by problems with ovulation. In the menstrual cycle, an egg is meant to be released from the ovary. In some cases, there are issues where an egg could be released in some cycles but not every cycle, or that the egg doesn’t get released at all. One of the treatments that could help with ovulation issues, is an oral medication called clomid or clomiphene, which can help stimulate natural ovulation, a treatment called ovulation induction.
Other causes include blocked fallopian tubes, fibroids or endometriosis. If the fallopian tubes are blocked, then sperm won’t be able to reach the egg after ovulation to fertilise it. A laparoscopic surgery could attempt to repair the fallopian tubes, depending on the location of the blockage and what caused it. In some cases, surgery would not be able to unblock the tubes and another option would be to proceed with IVF (in-vitro fertilisation). Fibroids can sometimes prevent a fertilised egg from implanting in the uterus. There are medications that can shrink fibroids, but large fibroids can be surgically removed. Endometriosis is a reproductive condition that can be painful and can cause fertility problems. Some endometriosis can be surgically removed but it might not increase your chances of conceiving. IVF may be an option when trying for a family.
Male factor infertility
A common cause of infertility in men is lowered sperm quality. This could be due to a decreased number of sperm, decreased sperm motility (how they move) or decreased morphology (how they look). Sometimes problems with sperm quality can be associated with hormonal imbalances, genetic problems, testicular damage or certain medications. In many cases, you may not be able to identify the cause of decreased sperm quality.
Depending on the results of your semen analysis, your doctor may recommend trying to conceive naturally for a little longer. Other options could include assisted reproductive treatments like IVF and sometimes with a fertilisation method called ICSI (intracytoplasmic sperm injection). ICSI is a fertilisation technique that could be offered if the sperm parameters are low. The technique entails injecting one single sperm directly into a mature egg, in order to fertilise it.
If you have unexplained infertility, it means that no cause has been determined for your fertility problems. In the UK, this accounts for roughly 1 in 4 cases of infertility. When no cause can be determined, the recommendation is to continue trying to conceive naturally for a total of 2 years, before any interventions are offered. Overall, 15% of couples with unexplained infertility will conceive within 1 year and 35% within 2 years. NICE (National Institute for Health and Care Excellence) guidelines state that fertility drugs have not been found to improve chances of conceiving compared to trying naturally. Since no active treatment is recommended, couples should be counselled on expectant management, which should include advice on lifestyle and successful conception.