According to the NHS, when the woman is under 40 years of age, more than 8 in 10 couples will conceive naturally within a year of having regular unprotected sex. But if you’re been TTC for longer than 18 months, and still nothing’s happening, you might want to start thinking about what happens next.
Fertility testing takes time, as does preparing for the actual treatment itself, so if this is the way things are going, it’s time to own it, and get yourself organised.
Firstly, contact your GP and put the wheels in motion for your initial fertility tests. Even if the NHS can’t support the actual fertility treatment itself, they should be able to help with the initial investigations to give you a bit of an insight into what’s going on.
Fertility questions and tests
You’ll be asked all sorts of questions in your first appointment with the GP. Don’t worry about feeling embarrassed, as this will quickly pass. (When it comes to fertility, you’ll soon experience embarrassment fatigue, believe me!) Be as open as you can – and remember, they’ve heard and seen it allllllll before!
They’ll ask about your sexual history, whether you have regular periods (so if you’re not tracking them already, download an app and get etching in dates now) as well as asking about any previous pregnancies or children.
They’ll ask you how often you have sex and when, and how long you’ve been trying. If you’ve been previously using contraception, they’ll want to know which, and how long you’ve been off it. It can take a while for some to fully leave your system.
The docs will also want to know about your lifestyle. So much can affect fertility; from stress, smoking, alcohol and drug use, to prescription medications and how much you weigh.
Once that’s all been discussed and any issues ruled out, it might be time for fertility tests to be booked.
Fertility tests for women
Hormone blood tests
- FSH (Follicle Stimulating Hormone) blood test taken menstrual cycle days 2-4. Used to check ovarian reserve.
- LH (Luteinising Hormone) – to check whether you’re ovulating.
- Progesterone test. Taken on day 21 on a regular 28-day menstrual cycle or 7 days before an expected menstrual cycle.
Imaging tests
- Transvaginal ultrasound to check the pelvis - womb and ovaries
- HyCoySy/ HSG tests to check for any blockages with your fallopian tubes after a special dye has been injected. This is performed around days 5-12 of your menstrual cycle.
Fertility tests for men
- Semen analysis to determine sperm quality (count, motility, morphology).
Get as many tests done on the NHS as you can if you’re looking at treatment at a private clinic, take confirmation of your results along with photographic ID, 2x passport photos each, and your NHS numbers.
Your to-do list: ask your GP/nurse
- Make sure your Rubella immunisation is up to date. Most adults need a booster and having this can delay treatment.
- Get an up to date smear test, or ask for a print out of the results (if you can’t locate them at home) if you’re still within the 3-year window.
- Book a sexual screening check for both of you through your GP. They’ll especially want to know about Chlamydia.
- Thyroid test, TSH.
- Get your Vitamin D levels checked – if it’s low, it can take a while to raise this level, and studies show, Vit D is linked to fertility…
Next time… how to choose a fertility clinic and what questions to ask…
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