When should we ask for help?
Infertility is the inability to conceive in spite of making love regularly without contraception. The average time to conceive is around six months in a healthy couple, so it is sensible to wait for a year before deciding that infertility may be a problem. 85-90% of couples can expect to have conceived by then.
It is therefore reasonable to wait at least 12 months.
Assuming that….
The women has a regular menstrual cycle (period 22-35 days)
Regular sexual activity
Absence of birth control
Exactly when medical advice is needed different for every couple. A major factor is the age of the women. The younger the women, the greater length of time to wait for natural conception, without medical intervention.
Something that applies for all ages of women, though, if there is no pregnancy after 2 years of trying then this warrants investigation.
What are the basic tests?
Checking ovulation and "quality" of eggs (oocyte)
Progesterone measurement by means of a blood test on the 21 day of the menstrual cycle (in cycles that are 28 days)
And/ or follicular monitoring by ultrasound until ovulation
The quality, to some degree, be determined by the level of the hormone FSH
Patentcy of Fallopian tubes (oviduct) and delineation of the uterus.
This is usually done by a hysterosalpingogran (HSG) -a method in which as dye is used to see the inside cavity of the uterus and fallopian tubes.
Semen analysis
There are also many tests in the investigation of infertility
Laparoscopy
Histeroscopy
Cervical mucus investigation
Complete hormonal assessment for both the couple.
Karyotype
On the basis of these results, the couple may:
Continue trying to conceive, without medical intervention, as the test reveal all is physiological
Or seek help from a fertility specialist.
If 18-24 months have passed and still no pregnancy, despite all test being normal then seek a fertility specialist.
