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What test and treatments can we expect in a fertility clinic?

Common medical tests

It may seem like there are many fertility tests but most of them are designed to assess four key elements for successful conception:

To find out whether hormone production is balanced, allowing for egg and sperm development
To establish whether the ovarian reserve is plentiful and ovulation is taking place
That sperm is of sufficient quantity and quality
To determine whether both male and female reproductive systems allow for fertilization

Read about fertility investigations men and women undergo.

Tests can take time. It may take two or three visits to your doctor to complete investigations over a one to six month period. Some of the tests will need to be repeated. During this time, it’s important not to become disheartened. The goal is to set a course of positive action for you and your partner to pursue.

Questions you may want to ask your doctor

The purpose of each test or investigation
Who will conduct the test
The type of test e.g. a physical examination or blood test?
Whether to expect any discomfort or pain
How long the results may take
Who will interpret the results?
What the next course of action will be

Low complexity treatments

The course you follow next will be different for each couple, depending on the results of tests and the kind of treatment you decide to pursue. You may start with any one of the following treatments, depending on the exact cause of the difficulty in conceiving:

A procedure at a day clinic
Oral medicine
Hormone treatment

Read about the kind of treatment you may expect to undergo at this stage of the investigation.

Millions of couples around the world go through fertility treatment every year. Up to one in ten couples experience difficulties in conceiving.² The vast majority can achieve a pregnancy at some stage along the treatment pathway.³ This is where the journey begins.

Questions you may want to ask your doctor

Which procedure has the greatest chance of success for us?
What are the side effects of this treatment?
What are our chances of having a baby if we have this treatment at this clinic?
How long will we have to be on this treatment before stopping or trying another treatment?
What are the risks of multiple pregnancies?
What should we do next if this treatment does not work?
What support or counselling is available?
What are the costs involved with this treatment and are they reimbursed?

Advanced treatments

If “low complexity” treatments do not bring success, Assisted Reproductive Technologies (ART) provide further options. With patience, a positive attitude and appropriate treatment, most couples eventually achieve their goal.³

Do not get discouraged if your initial course of treatment has not been successful. Discuss with your doctor when is the right time to seek help of a fertility specialist in a specialized fertility clinic. A specialized clinic will be able to offer a complete diagnosis and advanced treatment options – beyond your doctor’s care.

^{1. Collins J.A. Evidence-based infertility: evaluation of the female partner. International Congress Series 2004;1266; 57–62. 2. Boivin J et al, International estimates of infertility prevalence and treatment seeking: potential need and demand for infertility medical care. Hum Reprod. 2007;22; 1506-1512. 3. Pinbourg A et al, Prospective longitudinal cohort study on cumulative 5-year delivery and adoption rates among 1338 couples initiating infertility treatment. Hum Reprod.2009;24; 991-999.}

Obstetrician/Gynaecologist

A doctor who delivers babies and specialises in the treatment of female reproductive organs.

Oestrogen

A hormone that stimulates secondary female sexual characteristics and controls the course of the menstrual cycle. Oestrogen is also produced in low quantities in males.

Oligospermia

A condition when a sperm sample contains less than 20 million spermatozoa per ejaculate. Many medical conditions reduce sperm concentration. The effects may be temporary or permanent. See also Azoospermia.

Outpatient

A Person undergoing a clinical procedure that does not require admission to hospital.

Ovarian failure

The failure of the ovary to respond to hormonal stimulation from the pituitary gland because of damage to or malformation of the ovary, or a chronic disease such as autoimmune disease or ageing process.

Ovarian follicle

The structure in which eggs are nurtured to maturation. Although in general only one egg is released at a time, somewhere between 10 and 20 follicles begin the process of maturation monthly. The excess ovarian follicles are reabsorbed before ovulation occurs.

Ovulation

The release of the matured egg or ovum from the ovarian follicle.

Ovum

A matured egg.

Ovulation Induction (OI)

Medical treatment carried out to initiate ovulation.

Ovarian Hyper Stimulation Syndrome

A condition characterised by enlargement of the ovaries, fluid-retention and weight gain. May occur when the ovaries are over-stimulated during assisted reproduction.

Ovaries, Ovary

Almond-sized organ(s) located on either side of the uterus, which produce and release mature egg cells and the hormones oestrogen and progesterone.

Fallopian tube

A funnel-shaped passage through which sperm are guided towards the egg, and fertilized eggs are conveyed to the uterine cavity.

Fertilization

The moment of conception when the genetic material contained in the sperm and egg combine to create an embryo. Fertilization usually occurs inside the fallopian tube. It may also occur in vitro during a clinical process. See also In Vitro Fertilization.

Fertility treatment

Any procedure used to enhance fertility or to help couples achieve pregnancy.

Fertility psychologist

A health specialist with professional qualifications in psychology and counselling relating to fertility issues.

Fibroid tumour

A benign (that is, not malignant or life-threatening) tumour made up of fibrous tissue that may form in the uterine wall. Fibroid tumours may be present without any symptoms, or may cause abnormal menstrual patterns or infertility.

Follicle

A fluid-filled sac in the ovary, which contains the egg released during ovulation. Each month a new egg matures and travels to the fallopian tube.

Follicle Stimulating Hormone

A hormone released by the pituitary gland in both sexes. In women, FSH stimulates the growth of the ovarian follicle necessary for egg production. In men, FSH stimulates and supports sperm production. Elevated FSH levels are associated with gonadotrophin failure in both men and women.

Freezing

(See Cryopreservation)

Cervical mucus

A natural lubricant produced by the female body that aids the transportation of sperm and helps protect against infection.

Cervix

The cervix or neck of the uterus is the lower, narrow portion of the uterus where it joins with the top end of the vagina.

Chlamydia

A sexually-transmitted infection, which may be asymptomatic or cause genital inflammation and discharge, pelvic pain and fever. Untreated, chlamydia can lead to Pelvic Inflammatory Disease (PID) and fertility problems.

Chromosomes

Structures found in the nucleus of cells that contain genes and carry heredity information, such as eye colour, blood type and vulnerability to disease. Humans have 23 pairs of chromosomes. One set of 23 chromosomes is inherited from the biological mother via her egg and the other from the biological father, via his sperm. Each sperm cell contains either male or female sex chromosomes. As such, it determines the gender of the foetus. Genetic abnormalities occur when an individual is born missing a chromosome or has more copies of a chromosomal pair.

Clomiphene citrate

A prescription drug used to bring on ovulation. It comes as a tablet and is often used as an initial treatment for women with ovulation problems. Clomiphene citrate induces ovulation in 80% of women who have trouble ovulating on their own.

Conception

The moment of fertilization when the sperm meets and penetrates the egg.

Congenital abnormalities

Physical abnormalities present at birth.

Corpus luteum

A hormone-secreting mass within the ovary that forms from the remains of a follicle each time an egg is released. The hormones it produces prepare the uterus for embryo implantation. If pregnancy does not occur, the mass is shed during menstruation.

Cryopreservation

A technique used to store human tissue at very low temperatures. Embryos that are not used in an ART cycle may be preserved in this way for future use. Also known as “Freezing”.

Cryptorchidism

A condition usually detected at birth or childhood whereby the testicles fail to descend. When a male foetus develops in the uterus, his testicles normally form inside his abdomen and descend into the scrotum shortly before birth. Undescended testicles usually descend themselves by the sixth month of life, but are unlikely to descend after this period of their own accord.