Trying to become pregnant is inevitably a time of heightened hopes and fears. Hopes focus on images of a happy and contented pregnancy followed by a trouble-free birth and that magical moment when you hold your own baby in your arms. But fears are never far away either, and these can centre on general health and whether the time is right but above all on the prospect of infertility and whether infertility treatment will be necessary. Even those who already have a child could well be aware that secondary infertility is more common than primary infertility, their fears intensifying accordingly.

In this article we offer a simple roadmap to guide you through the unknown landscape of infertility treatment, with the five top topics to raise with your doctor. We also offer a few tips to help you get the best benefit from your doctor’s appointment.

1. Should we have fertility tests now, or wait a bit longer?

Your doctor will be able to judge the answer to this after taking the personal and medical histories of both you and your partner into account. The general consensus among fertility experts is that for people under the age of 35, if you have not conceived within a year of having regular unprotected sex, it’s time to check if there is a problem. Where the woman is over 35, because of the well-known decline in fertility after this age, it is better to seek advice after six months.

2. What is the cause of my infertility?

Again, this may be better answered after running some tests but your doctor may be able to offer an overview as to the likely causes. In general, 30% of infertility has its cause with the female partner, 30% is due to male infertility and for the rest, it could be the result of a combination of both partners, or the cause could be unidentifiable. In cases of female infertility, the most common causes include:

Your doctor will keep these common causes of infertility in mind when assessing recommendations for the next steps.

3. What are the specific tests for infertility?

Specific tests will naturally depend on your circumstances. However, your doctor can advise you on the broad range of tests which are the basics for most people, whether they are experiencing primary or secondary infertility. These include taking your complete medical history and there will also be a physical examination of both you and your partner.

4. Are there any lifestyle measures we could take?

It’s definitely a good idea to ask your doctor about lifestyle issues and general health. Optimum health can help not only with conception but also throughout the pregnancy and birth. For example, it’s well-known that taking a folic acid supplement is a necessary precaution before rather than after conception. You could also ask about whether it’s OK to continue to enjoy a glass of wine with dinner, whether your coffee consumption is problematic and about weight management. There are some occupational hazards that may affect your chances of conception as well, so be sure to ask your doctor about any and all of the lifestyle issues that are relevant for you.

5. What are our options for infertility treatment?

Your doctor will be able to give you a broad brush picture of the choices available based on your individual circumstances. It could be that you would firstly be recommended to try intrauterine insemination, one of the simplest and least invasive treatments. Or the well-known technique of in vitro fertilisation (IVF) could be the recommended treatment, one which has resulted in the birth of more than eight million babies worldwide since 1978, according to the European Society of Human Reproduction and Embryology. You can see that you would be in good company! There are also options for pre-implantation genetic testing combined with IVF where there is a medical indication of an inheritable genetic disease.

For a summary of the options, take a look at our blog article about infertility treatment at a glance.

A few more tips to maximise the benefit from your appointment

Help your doctor to help you by taking with you some key items of information. For a start, do write down your list of questions to make sure nothing is omitted or forgotten. Other relevant information includes:

• the dates of your last six or so periods, to help assess whether irregular ovulation is a contributory factor;
• a full list of any medications you are taking, since some can hinder conception and others, even over-the-counter medicines, can be unsafe during pregnancy;
• being open about all your symptoms, even if you feel embarrassed; your doctor has heard it all before and the more information you supply, the more easily she can help.

Finally, don’t forget to ask about how to choose the right fertility clinic and how to make sure it is one which is licenced and accredited by the relevant authorities. If, as a result of your consultation, you are considering consulting us at IVI, have a look at our video about what to expect from your first visit. And then? The only thing left to do is to go ahead and make an appointment!