Infertility Evaluation & Treatment

When to Seek Fertility Help

Understanding when to consult a fertility specialist can help you take proactive steps. We recommend scheduling an evaluation based on these key clinical indicators.

Under Age 35

Ages 35 to 39

Age 40 and Over

If you are under 35 and have been actively trying to conceive for 12 months or more, it is recommended to begin a basic fertility evaluation.

For women aged 35 to 39, we advise seeking a consultation after 6 months of regular, unprotected intercourse to optimize your window of opportunity.

If you are 40 or older, we recommend a proactive evaluation when you decide to conceive, as ovarian reserve naturally declines more rapidly.

Irregular Cycles

Recurrent Miscarriage

If you experience irregular, painful, or absent periods, or have a known diagnosis of PCOS or endometriosis, early clinical evaluation is key.

If you have experienced two or more consecutive pregnancy losses, specialized testing can help identify underlying causes and guide your future success.

Common Causes of Female Infertility

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Ovulation Disorders

Irregular or absent ovulation can occur with PCOS, hormonal disorders and several other conditions.

PCOS

Polycystic ovary syndrome may cause irregular ovulation and difficulty conceiving in some women.

Tubal Factors

Previous pelvic infection, surgery or other conditions can affect the fallopian tubes and interfere with fertilisation.

Endometriosis

Endometriosis may affect fertility through changes involving the ovaries, fallopian tubes and pelvic environment.

Uterine Factors

Fibroids, polyps, adhesions and certain structural abnormalities may sometimes interfere with implantation or pregnancy.

Age-Related Fertility Decline

Female fertility gradually decreases with age, with a more significant decline occurring in the later reproductive years.

Comprehensive Fertility Evaluation

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🩺 Medical & Menstrual History

A detailed assessment of menstrual cycles, previous pregnancies, medical conditions, medications, previous surgery and reproductive history helps guide further evaluation.

🧪 Hormonal Assessment

When clinically indicated, blood investigations may be advised to assess ovulation, ovarian function, thyroid status, prolactin and other relevant hormonal factors.

🩻 Ultrasound & Reproductive Assessment

Pelvic ultrasound can help assess the uterus, endometrium and ovaries and identify conditions such as fibroids, ovarian cysts or features suggestive of PCOS.

👩‍❤️‍👨 Couple-Based Evaluation

Fertility assessment should not focus on the woman alone. Evaluation of the male partner, including semen analysis when appropriate, is an important component of infertility assessment.

Investigations That May Be Recommended

Investigations are selected according to the couple's individual circumstances rather than ordering every test routinely.

Possible investigations include:

For the woman

• Pelvic ultrasound

• Assessment of ovulation

• Thyroid function tests

• Prolactin

• Ovarian reserve assessment when indicated

• Assessment of tubal patency when appropriate

• Additional hormonal or imaging investigations according to clinical findings

For the male partner

• Semen analysis

• Further specialist evaluation when abnormalities are identified

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Personalised Treatment Approach

Treatment Begins With the Cause

Infertility treatment is not the same for every couple. Management depends upon age, duration of infertility, menstrual and ovulatory status, ovarian reserve where relevant, tubal factors, semen parameters and other medical conditions.

Depending upon the findings, management may include:

Lifestyle & Preconception Optimisation

Healthy body weight, balanced nutrition, physical activity, avoidance of smoking and appropriate preconception supplementation can support reproductive health.

Ovulation Management

Women with ovulatory disorders may require targeted treatment and monitoring according to the underlying cause.

Treatment of Gynaecological Conditions

PCOS, thyroid disorders, endometriosis, fibroids and other conditions may require appropriate management as part of fertility care.

Timed Intercourse

For selected couples, identifying the fertile period and appropriately timing intercourse may be sufficient.

Referral for Assisted Reproductive Treatment

When indicated, couples can be referred for specialist fertility treatment such as IUI or IVF after appropriate evaluation.

Fertility & PCOS

Trying to Conceive With PCOS?

PCOS is one of the common causes of irregular ovulation. However, having PCOS does not mean that pregnancy is impossible.

Management may include lifestyle optimisation, assessment of ovulation and metabolic factors, and appropriate medical treatment when required.

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Fertility and Age

Why Age Matters

Female fertility changes with age because both the number and quality of available eggs decline over time. Age therefore becomes an important consideration when deciding how long to try naturally and when to begin fertility evaluation.

Women in their mid-30s and beyond may benefit from seeking assessment earlier rather than waiting for a full year.

Preparing for Pregnancy

Before conception, attention may also be given to:

• Folic acid supplementation

• Nutrition and healthy weight

• Diabetes and thyroid control

• Review of medications

• Vaccination status where relevant

• Smoking and alcohol avoidance

• Management of chronic medical conditions

• Identification of pregnancy-related risk factors

Preconception care helps prepare for both conception and a healthier pregnancy.

FAQ SECTION

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How long should we try before consulting a doctor?

For many couples where the woman is under 35, evaluation is generally considered after 12 months of regular unprotected intercourse. Earlier assessment may be appropriate depending on age or known medical factors.

Can PCOS cause infertility?

PCOS can interfere with regular ovulation and may make conception more difficult, but many women with PCOS conceive naturally or with appropriate treatment.

Does infertility always mean IVF is required?

No. Treatment depends on the underlying cause. Many couples do not require IVF.

Should the male partner also be evaluated?

Yes. Fertility evaluation should generally consider both partners.

Can fibroids affect fertility?

Some fibroids can affect fertility depending on their size and particularly their location, while many fibroids have little or no effect.

Can infertility be unexplained?

Yes. In some couples, standard investigations may not identify a definite cause despite difficulty conceiving.

Key Fertility Investigations

A comprehensive fertility evaluation helps identify the precise factors affecting conception. We perform targeted, evidence-based investigations to design your personalized treatment plan.