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Conditions

IVF and reproductive medicine · Fertility

Infertility

Understand difficulty achieving pregnancy and prepare for an assessment involving everyone concerned.

Editorial publication · Medical review pending.

Understand

Infertility is a disease of the reproductive system, classically defined by failure to achieve pregnancy after at least twelve months of regular unprotected intercourse. Earlier assessment may be appropriate because of age, history or a known cause.

Possible symptoms

The main sign is not achieving pregnancy. Irregular cycles, pelvic pain, sexual difficulties or a testicular history can guide assessment, but infertility may have no other symptoms.

Causes and associated factors

Ovulatory, tubal, uterine, sperm, hormonal, genetic or treatment-related factors may contribute. Several factors can coexist, and sometimes no cause is identified.

Diagnosis

Assessment considers the duration of trying, previous pregnancies, age, cycles, medical, surgical and sexual history, medicines and lifestyle together, without automatically assigning the cause to one person.

Tests

Depending on the situation, testing may include confirmation of ovulation, ultrasound, tubal assessment, semen analysis and targeted hormone tests. Not every test marketed by clinics is routinely useful.

Course of the condition

Chances of conception and response to care vary with the cause, age and duration of infertility. Treatment may involve several stages and cannot guarantee a live birth.

Care options

Care may include information, treatment of an identified cause, ovulation induction, selected surgery, insemination, IVF, ICSI or donation. Psychological support is part of good fertility care.

When to consult

Seek advice after twelve months of trying, or earlier with higher maternal age, very irregular or absent periods, previous cancer treatment, pelvic infection, surgery, pain or a known testicular problem.

Urgent help

Infertility itself is not usually an emergency. Severe pelvic or testicular pain, fainting, heavy bleeding, fever or breathing difficulty still needs urgent assessment.

Questions for your doctor

  • Which cause or combination of factors explains our fertility difficulty?
  • Which tests are genuinely useful before deciding?
  • Which options exist before or instead of IVF?
  • Which benefits, limits, risks and costs should we compare?
  • What support and reassessment timeline should we plan?

Continue reading

A procedure linked to a condition does not establish an indication for your individual situation.

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