Fertility investigation Q&A

Christopher SteerMr Chris Steer is a Consultant Gynaecologist at BMI The Sloane HospitalBMI Chelsfield Park Hospital and BMI Blackheath Hospital.
Mr Steer is an expert in fertility and can offer total care through both the fertility treatment and the subsequent antenatal care and the delivery of the baby.
Here he explains everything you need to know about fertility investigations. Visit our dedicated section to find out more about fertility.

Mr Chris Steer
This is a blood test for the woman on day 21 from the start of her period to make sure that she is releasing eggs, along with an ultrasound scan to make sure that the womb and ovaries are normal and a fluid (hycosy) to be put through a catheter into the neck of the womb to flush out the tubes.

If anything wrong is found it can either be repaired or in some cases like blocked tubes bypassed and IVF (test tube baby) offered.

For the man a sperm count is checked after 3 days abstinence from sexual activity by producing a sample from masturbation and the semen analysed within an hour of production.

Mr Chris Steer
A normal couple with a fertile male and the woman under 35, will have a chance of conception of approximately 90% in 12 months of regular intercourse.  After 12 months or earlier if the woman is over 40, then it is a good idea to check that all is normal and time isn’t wasted.

Mr Chris Steer
It is usually best to see a gynaecologist with a special interest in fertility although the initial blood tests and sperm count can be checked by your GP.

Mr Chris Steer
To access NHS investigations your GP will have to refer but privately it isn’t required.

Mr Chris Steer
The NHS wait for a clinic is typically 12 weeks, but privately can be 1 or 2 weeks depending on the time of year popularity of the clinic and demand.

Mr Chris Steer
These are normally within a week to confirm the release of the eggs (progesterone) blood test and a week for the sperm count.  A very basic sperm count can be done as a positive or negative self-test in a few minutes from the pharmacy store.

Mr Chris Steer
This is in the month following the test with tablets e.g. Clomid for not releasing eggs or 3 to 6 months for NHS IVF if available in the area you live.

Mr Chris Steer
A woman should eat healthily not smoke and have a BMI body mass index between 19 and 35. Around 25 is ideal so adjusting weight to achieve this and avoiding stress if possible are all beneficial.

If not releasing eggs, then tablets are taken for 5 consecutive days in the beginning of the menstrual cycle. If the scan or history suggests endometriosis (pain before the periods and possible ovarian cysts) then this can be repaired with a key hole operation with a little telescope inserted into the belly button when asleep. This is also used to remove ovarian cysts, uterine fibroids or to unblock fallopian tubes blocked e.g. with chlamydia.

To improve a man’s sperm count he shouldn’t smoke he should only drink moderate amounts of alcohol, not take recreational drugs and eat healthily. Supplements have also been found to help improve the quality of sperm.

If the tubes can’t be unblocked or the sperm count remains poor or endometriosis is the cause and even unexplained infertility of more than a year, then IVF is often suggested with the sperm injected into the egg if the count is low (ICSI).

Mr Chris Steer
No fertility treatment has 100% success each month so if the tablets don’t work the first month and the day 21 progesterone blood test is normal then repeating for up to 6 months is a good idea. However, if the woman is over 35 and treatment isn’t working then natural conception should be abandoned and IVF tried.

After treatment for natural conception move onto a more complex treatment if not pregnant until a pregnancy is achieved.