There can be many reasons why couple fail to conceive spontaneously or have recurrent miscarriages and in some cases can remain unexplained once all ivnestigations are complete. Couples should seek help after 6-12 months of infertility, or sooner if the woman is over 35.
Other reasons to seek help earlier may be irregular or absent periods, painful periods, a previous history of inferlity or a history of gynaecological problems such as endometriosis, fibroids or pelvic infection. A thorough history will be taken and then appropriate tests ordered. This will involve blood tests to assess ovulation and egg reserve, assessment of the fallopian tubes and a semen analysis. Sometimes an operation involving a laparoscopy and hysteroscopy to assess the pelvis and uterus further may be indicated. Other tests would be based on the information gathered at the consultation. A management plan would then be discussed and if and when assisted fertility treatments such as IVF are needed, appropriate referral can be made.