Fertility tests and treatment

If you don’t get pregnant, what treatment is available? Guidance from The Family Planning Association

If you’ve been trying for over a year to get pregnant, or you are over 35 and have been trying for six months, then it is worth seeing your doctor. Your GP may refer you to a consultant at your local hospital or a specialist fertility clinic for further investigations. Treatment for infertility within the NHS is limited and waiting lists vary. When you see your GP ask him what is available locally on the NHS and if there is a limit to the help you’ll receive. Check too about the cost of any prescribed drugs. Will the practice pay or will the bill come to you? If you want treatment privately, your doctor will tell you about clinics in the area. Phone them to get information about the tests and treatments they offer, waiting times and the costs involved. Then ask your GP to refer you to the clinic you’ve chosen.

When you see the specialist you’ll have limited time for the consultation. Take a list of questions you want to ask. You may have waited a long time for this appointment and you may wait a long time for the next.

Tests for a woman may involve:

  • Blood, urine and cervical mucus tests – to check hormone levels or ovulation.
  • Ultrasound scans – to check if a follicle, which should contain an egg, is being produced. Treatment for ovulation problems usually involves drugs and has a high success rate.
  • Sperm mucus crossover – this checks if the woman’s cervical mucus allows her partner’s sperm through.
  • Endometrial biopsy – a sample of womb lining (endometrium) is removed to check that it is free from infection and that ovulation has occurred.
  • Hysterosalpingogram – where dye is passed through the fallopian tubes to check they are not blocked.
  • Laparoscopy (usually under general anaesthetic) – uses a thin telescopic instrument to view the reproductive organs through a small cut below the navel. It checks for scar tissue, endometriosis, fibroids or any abnormality in the shape or position of the womb, ovaries or fallopian tubes.

Tests for a man may involve:

  • Semen analysis to look at the number, shape and size of sperm, as well as the way they move.
  • Blood or urine tests to check hormone levels.
  • Testing the sperm in special solutions.
  • Special X-rays/scans to find blockages or check the blood supply to the testes.
You’ll probably go through a range of tests because a couple can have a combination of problems that cause infertility. Once you have a diagnosis you may just need straightforward treatment or surgery to help you conceive. If the tests aren’t conclusive, assisted conception may still be successful. The techniques listed are not miracle solutions. Whatever the treatments available, a woman under 35 will stand a much better chance of a successful pregnancy than a woman over 40.

Assisted conception techniques include:

  • In-vitro fertilization (IVF) – the most well-known treatment. Eggs are removed from the woman, fertilised in the laboratory and the embryo is then placed in her womb. 80% of in-vitro fertilisation (IVF) treatment is carried out privately. Your GP, practice nurse or local Community Health Council (CHC) will tell you if you qualify for treatment on the NHS. You can also visit The Human Fertilisation and Embryology Authority website for more information.
  • Donor insemination (DI) Egg donation may be an option if a woman is not producing eggs or has a genetic problem. If a man produces no or few normal sperm or has an inherited disease, insemination using sperm from an anonymous donor may be an option.
  • Gamete Intra-Fallopian Transfer (GIFT) – a couple’s own eggs and sperm, or that of donors, are mixed together and placed in the woman’s fallopian tubes where they fertilise.
  • Intra-cytoplasmic Sperm Injection (ICSI) – a single sperm is injected into the woman’s egg, which is then transferred to the womb after fertilization.
Counselling and support
Undergoing treatment for infertility is stressful. Lots of hospital visits are involved with long waits in between to see if treatment has worked. It can be easy to despair or get so anxious about having a child that nothing else matters. Relationships, including sexual relationships, can be put under a lot of strain. If you’d like to talk to people who understand what you’re going through, CHILD The National Infertility Support Network and ISSUE (The National Fertility Association) are organizations run by and for people with fertility problems. Support and counselling are also available at specialist fertility clinics.

If treatments don’t work and you feel you cannot give any more time and energy to trying to have a child, ISSUE can help you through this difficult process.

For more information about IVF see related articles:
target="new" class="promo">IVF - what you need to know.
Infertility treatments in the future.
Fertility at forty, or even thirty.
The cost of IVF

Or visit: The Family Planning Association website or ring their helpline on 0845 3101334