What are among the preliminary exams that will probably be carried out?
“At the very minimum, you should have a full hormone panel done between days two to five of your cycle, covering FSH, LH, oestrogen, prolactin, TSH, SHBG and testosterone, as well as a standalone progesterone test around six to seven days after ovulation. It can also be helpful to get your levels of vitamins D and B tested as well as CRP (an inflammation marker), and a transvaginal scan to check for uterine abnormalities such as fibroids, polyps, or conditions that affect the uterine lining such as adenomyosis. An expert should also look to rule out hormonal imbalances that may be affecting ovulation, such as thyroid disorders, high testosterone, or polycystic ovary syndrome (PCOS), which can affect egg quality and the uterine lining.” – Rachel Sherriff, fertility acupuncturist & founding father of The Fertility Suite
“Your GP should also recommend a full semen analysis to establish the health and motility of the sperm, as well as sperm count, and a screening for sexually transmitted diseases, as some can directly impact male fertility. An examination of the testicles and penis will also rule out any lumps, deformities or potential abnormalities.” – Lesley
What are among the most typical issues found?
“In approximately 30% of couples who struggle to conceive, there are issues relating to male fertility. These range from erectile or ejaculation dysfunction, to low sperm count, suboptimal sperm health (their morphology – shape – and/or their motility), blockages in the male reproductive system, and prostate problems. In another 30% of couples struggling to get pregnant, the issues are related to female fertility and can include ovulatory problems, conditions affecting the uterus (like endometriosis), PCOS and blocked fallopian tubes. A combination of fertility issues affecting both the man and the woman (for example, a low sperm count and issues with ovulation) is reported in 20% of couples who struggle to have a baby, while for the remaining 20% of cases, the causes of infertility is unknown.” – Lesley
“Often, the male side of things is under investigated and more emphasis is placed on the woman. In around 40% of couples struggling to conceive, the man will have an undiagnosed varicocele. The World Health Organisation (WHO) now recommends a sperm DNA fragmentation test should be included as part of the standard fertility mark-up. An inability to conceive could also come down to an undiagnosed thyroid condition. Low levels of thyroid hormones can hinder ovulation and increase miscarriage risks, but symptoms can overlap with other conditions or can be considered ‘normal’, such as tiredness, sluggish bowels or dry skin. Therefore, women fail to get the diagnosis or treatment they need to optimise their hormones for fertility.” – Rachel