What Are The Causes?
Female Problems
- The ovaries are not releasing eggs (anovulation) or the eggs are immature
- Hormone imbalances or deficiencies
- Genetic abnormalities
- Damaged, blocked or absent fallopian tubes
- The lining of the womb does not develop properly
- Endometriosis
- Previous infections (particularly sexually transmitted infections)
- Previous surgery for ovarian cyst(s)
- The lubricating mucus from the cervix (neck of the womb) is hostile
Male Problems
- Hormone problems
- Genetic abnormalities
- Sexually related problems
- Retrograde ejaculation
- The tubes that carry the sperm are damaged, blocked or absent
- Previous inflammation of the testes (caused by virus or bacteria)
- Previous surgery to correct undescended or twisted testicles
- Varicocele
- Drug treatment or previous radio/chemotherapy for cancer
When to Investigate
- Couples who have not conceived after a year of regular unprotected sexual intercourse
- Couples who have a known cause of infertility, have predisposing factors, or where a woman is aged 35 years or over should be offered early investigations.
Assessing Reproductive Performance
To assess the fertility performance of both male and female, on the first visit to the clinic a full medical history is taken, followed by a series of first line basic tests:
Female tests:
- Hormone blood tests on day 2 to 5 of menstrual cycle
- Blood test for rubella (German measles) immunity
- Blood or urine test for Chlamydia screening
- Pelvic ultrasound scan
Further investigations may be discussed and organised on an individual basis if any of the above tests show not to be within the recommended range.
Male tests:
- A semen analysis will be required to be arranged, and has to be produced within the premises of an Andrology laboratory.
