Not being able to conceive doesn’t automatically mean you’re infertile. However, if you’ve been trying for a while, or feel there is a problem, here is the next step to take.

When should I see my GP?

The common advice is, if after a year of regular sex you’re still not pregnant, see your GP, but if you are aged 35 or over, and/or have a pre-existing condition the advice is to consult your GP after six months. Around one in seven couples in the UK are what’s known as sub-fertile, which means they are less fertile than a typical couple and need help getting pregnant.

How can my GP help?

Aside from being able to arrange an appointment with a fertility specialist at your local NHS hospital, your GP will be able to run some basic tests. He can check your hormone levels via a blood test, and test for sexually transmitted infections that may be hindering conception such as Chlamydia and arrange a smear test.

How long will I have to wait for a hospital appointment?

Hospital tests to find out why you can’t conceive are free on the NHS but waiting lists are long. If you can afford it you can choose to be referred to a private clinic (your GP can advise you on clinics).

What will happen at my hospital appointment?

• Your consultant will ask you for a detailed history on your general health and ask you questions such as:
• How long you have been ‘trying’ for a baby?
• How often you make love?
• Have you ever suffered from any pelvic infections?
• Have you ever miscarried?
• Have you suffered an ectopic pregnancy?
• Has your partner suffered from any testicular problems?

What next?

A series of tests are likely to be arranged. “The tests,” says midwife Zita West (www.zitawest.com) “aim to eliminate possible causes of problems and most, even the invasive surgical ones, are quite routine and shouldn’t give you too much cause for concern.” However, it’s important to know that about 30% of couples find no reason for their infertility, whilst the remaining 70% can be attributed to problems of either or both partners that can hopefully be treated.

What are the exact tests?

“Tests carried out on men mainly involve the collection and analysis of sperm samples. Further tests on the testicles may sometimes be required. Tests carried out on women are more varied and include the following” says midwife Sharon Trotter, (www.tipslimited.com):

• Blood tests – these will detect a hormone imbalance and indicate whether or not you are ovulating.
• HSG (Hysterosalpingogram) test– This is carried out once ovulation has been checked and the aim is to look for blockages in your tubes or uterine problems such as Endometriosis or fibroids that might be preventing pregnancy from occurring. Laparoscopy – if there is a blockage a laparoscopy under general anaesthetic is then usually performed. This is like a small telescope that shows the doctor a closer look at the problem.
• Post Coital Test (PCT) – This involves an internal examination of the cervix approximately 6-24 hours following sexual intercourse, at the time of ovulation. A sample of cervical mucus is obtained and examined under a microscope to see if there are live sperm and if they appear to be swimming well. If this is a positive result then there is no problem. If the result is negative, there will need to be further examinations.
• Specialist screening if you still have no answers may also be offered especially if you have a history of miscarriage and/or unexplained infertility. These will look at your immune system, and your antibodies.

If there is a problem, what types of treatment are available to us?

“Depending on your circumstances there are a range of options available”, says Sharon Trotter (www.tipslimited.com) such as:

• Drugs to stimulate the ovaries and/or regulate ovulation, which accounts for *20% of infertility problems. The most common drug is ‘Clomiphene’, better known as ‘Clomid’.
• Tubal Surgery: Blocked or damaged tubes can account for as much as 15% of fertility problems in women.
• Surgery for Endometriosis – which accounts for 10% of fertility problems in women.
• Intra-Uterine-Insemination (IUI) where sperm is collected and sorted so that only the strongest sperm remai. This is ideal for couples where the man’s sperm is ‘slow’ or low (25% of infertility problems).
• Assisted conception and IVF – it’s vital to do your research on this before agreeing to anything. <* all statistics 2007>

What if we’re in the 30% with unexplained infertility?

“The most common cause of infertility is unexplained,” says Dr Marilyn Glenville, author of Natural Solutions to Infertility (Piatkus Books) “which means that following investigations, doctors can find no specific medical problem at the root.” This is where a natural approach or IVF can come into play.

The natural approach means looking at lifestyle factors, nutritional deficiencies and even emotional elements in your life. For more information on this go to www.drmarilynglenville.com, Zita West www.zitawest.com. For IVF and Assisted conception For up to date information go to The Human Fertilization and Embryology Authority (HFEA) www.hfea.gov.uk