We are a heterosexual couple

Approximately 1 in 6 couples will experience subfertility. There are several possible causative factors but broadly speaking the causes are

  • One third female fertility problems e.g low egg numbers, blocked Fallopian tubes, endometriosis
  • One third male fertility problems e.g. low sperm count, poor sperm motility
  • One third both male and female problems

A number of couples will have no explanation for their subfertility- this is known as unexplained subfertility.

You can refer yourself to the clinic or refer via your GP/consultant for a consultation with one of our fertility specialists.

What to expect at your consultation

A full history including medical and surgical history, lifestyle factors will be taken from both partners. The consultant will review the results of any investigations you have had performed prior to the consultation. A transvaginal ultrasound scan will be performed as part of your first consultation in order to assess the uterus (womb), ovaries and pelvis.

The consultant will discuss the results in detail with you and recommend, where necessary, any further tests (e.g. tubal patency test, sperm preparation). You will also be advised on the best management for your particular situation.

Investigations

Both the male and female partner must be investigated to identify any underlying cause for their difficulty conceiving

Female Investigations:

Blood test:

  • Day 2,3, or 4 hormone profile (FSH, LH, oestradiol)
  • Thyroid functions tests
  • Prolactin
  • Anti-Müllerian hormone level (AMH)

Ultrasound
Transvaginal ultrasound to assess uterus, ovaries and pelvis

Tubal patency test
laparoscopy and dye test or hysterosalpingogram (HSG) to ensure the Fallopian tubes are not blocked

Viral screening
Prior to undergoing any fertility treatment both partners require screening for HIV, Hepatitis B and C

Male investigations:

  • Semen analysis
    To assess sperm count, motility and morphology
  • Viral screening
    Prior to undergoing any fertility treatment both partners require screening for HIV, Hepatitis B and C

Treatment options

The treatment options available to couples very much depend on the underlying cause.

The following treatments are available at Waterstone Clinic

  • Ovulation induction (OII) with follicle tracking
    OII is used in situations where the woman does not ovulate regularly e.g. polycystic ovarian syndrome
  • Intrauterine insemination (IUI)
    IUI is most commonly used for couples with unexplained subfertility.
  • In vitro fertilisation (IVF)
    IVF is the treatment of choice in situations of diminished ovarian reserve, blocked Fallopian tubes, endometriosis.
  • Intracytoplasmic sperm injection (ICSI)
    ICSI is an advanced laboratory technique used in an IVF cycle when the male partner has poor sperm quality.
  • Donor sperm treatment
    Some heterosexual couples require donor sperm for treatment in situations where there is azoospermia (no sperm in the ejaculate) and no sperm can be retrieved surgically.
  • Donor egg treatment
    Some heterosexual couples will require donor egg treatment in situations where the female partner has severely diminished ovarian reserve, premature ovarian insufficiency or intractably poor embryo quality.

Find Out More

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