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What causes infertility?

The commonest causes for delay in conception are summarised below and as many as 1 in 6 couples are affected.

  • Ovulatory causes (e.g. polycystic ovarian syndrome)
  • Male factor (e.g. low sperm count)
  • Tubal disease (e.g. from scarring due to infection or endometriosis)

However there are some cases in which infertility is unexplained. Couples having regular intercourse where the woman has regular periods and no obvious risk factors should be reassured that it is normal to take up to a year to conceive. This advice is clearly not appropriate for older women or for those with symptoms and this group should consider tests to investigate potential problems.

A fertility check up includes taking a detailed medical history and examination where appropriate.


What are the symptoms to look out for?

If you present with any of the following symptoms whilst trying to conceive, we advise that you book to see a specialist who will carry out tests.

  • Irregular, infrequent or absent periods
  • Pelvic pain and/or pain during intercourse
  • History of pelvic infection or pelvic surgery eg for appendicitis

Available tests

Tests to understand the cause of complications with conceiving include:

  • Hormone profile (timed for the correct time in your menstrual cycle)
  • Pelvic ultrasound scan to check for fibroids, endometriosis
  • Sexual health screen
  • Test of fallopian tube function
  • Semen analysis
  • Laparoscopy where appropriate (eg in women with pelvic pain or an abnormality suggestive of pelvic disease on ultrasound). The advantage of laparoscopy in this setting is that it allows both comprehensive assessment of the pelvis but also treatment that may improve the chance of conceiving.