Infertility can be a distressing and challenging experience for couples trying to conceive. Infertility is defined as the inability to conceive after a year of regular, unprotected sexual intercourse. According to the NHS, one in seven couples in the UK may experience difficulties conceiving. Infertility can be caused by a range of factors, both in men and women. In this blog post, we will explore how to recognise signs of infertility and what tests are available for identifying infertility.
What are the best indicators of fertility in women?
A woman's menstrual cycle is a vital sign of her fertility. A regular menstrual cycle of 24 to 35 days and consistent periods every month is a good indication of fertility. In addition, cervical mucus is another sign of fertility in women. During ovulation, the cervical mucus becomes clear, stretchy, and watery. This consistency helps sperm to move easily through the cervix into the fallopian tubes, where fertilisation occurs.
While a regular menstrual cycle and cervical mucus consistency are positive indicators of fertility, there are certain signs and symptoms that may suggest a woman is struggling with infertility. Some of the most common signs of infertility in women include:
Irregular periods: A regular menstrual cycle usually indicates healthy ovulation and fertility. Women with irregular periods may not be ovulating regularly or at all, which can make it difficult to conceive.
Painful or heavy periods: Painful periods or heavy bleeding may indicate an underlying condition, such as endometriosis or uterine fibroids, that can affect fertility.
Age: A woman's age is one of the most significant factors in determining fertility. As women age, their egg quality and quantity decline, making it more challenging to conceive.
Hormonal imbalances: Hormonal imbalances, such as polycystic ovary syndrome (PCOS), can cause irregular periods, weight gain, and acne, which can all impact fertility.
Pelvic pain or inflammation: Pelvic pain or inflammation may indicate an infection or other underlying condition that can affect fertility.
Previous pelvic surgery: Surgeries such as ovarian cyst removal or tubal damage can increase the risk of infertility and ectopic pregnancy.
Family history: A family history of early menopause or other reproductive problems may increase a woman's risk of infertility.
It's important to note that many of these signs and symptoms are not specific to infertility and can have various causes. It's essential to speak to a consultant gynaecologist with fertility experience if you're experiencing any of these symptoms or have concerns about your fertility. A medical evaluation can help determine the underlying cause and the most appropriate treatment options.
When to consider whether my partner or I may be infertile?
If you have been trying to conceive for a year or more without success, it is essential to seek medical advice. However, it is advisable to seek help earlier if you or your partner is above the age of 35, or if you have a known medical condition that may affect fertility, such as Polycystic Ovary Syndrome (PCOS), endometriosis, or a history of pelvic infections or sexually transmitted infections (STIs).
If you and your partner have been trying to conceive for a year or more without success, it may be time to consider whether one or both of you may be experiencing infertility. However, there are certain factors that may indicate a need for earlier medical evaluation.
One of these factors is age. As women age, their fertility naturally declines, with a more significant decline typically starting after the age of 35. If you or your partner is over the age of 35 and has been trying to conceive for six months or more without success, it may be time to seek medical advice. Age factor is also a challenge to men fertility due to the increase in poor quality sperms with advancing age.
Another factor to consider is any known medical conditions that may affect fertility. For example, conditions such as Polycystic Ovary Syndrome (PCOS) and endometriosis can affect a woman's ability to conceive. If you or your partner has been diagnosed with one of these conditions or has a history of pelvic infections or sexually transmitted infections (STIs), it may be advisable to seek medical evaluation earlier than the one-year mark.
It is also essential to consider lifestyle factors that may impact fertility. For example, smoking, excessive alcohol consumption, and being significantly overweight or underweight can all affect fertility in both men and women. If you or your partner has any of these risk factors, it may be worth discussing with a healthcare provider whether earlier medical evaluation is appropriate.
Ultimately, if you have concerns about your fertility, it is always better to seek medical advice sooner rather than later. Infertility can be a complex issue with a range of underlying causes, and early medical evaluation can help determine the cause and the most appropriate treatment options. Your consultant can help guide you through the evaluation process and provide support and advice throughout your fertility journey.
Infertility warning signs
Some warning signs of infertility in women include irregular periods or painful periods, heavy or light periods, or no periods at all. Painful sex and abnormal vaginal discharge may also indicate infertility. In men, infertility warning signs may include a low sperm count or difficulty achieving or maintaining an erection.
What causes infertility?
Infertility can be caused by several factors, both in men and women. The causes of infertility in women can range from ovulatory disorders, hormonal imbalances, or problems with the reproductive organs. In men, the causes of infertility may include low sperm count, poor sperm motility or quality, or problems with the reproductive organs.
Infertility causes in females
Some of the common causes of infertility in women include age, hormonal imbalances, Polycystic Ovary Syndrome (PCOS), endometriosis, damage or scarring of the fallopian tubes, or uterine problems.
Infertility causes in males
In men, infertility can be caused by low sperm count, poor sperm motility, or quality, or problems with the reproductive organs. Other factors such as lifestyle habits, such as smoking, excessive alcohol intake, and drug use, may also contribute to male infertility.
What tests are available for infertility? Infertility tests for women
Infertility can be a difficult and stressful experience for many women. However, there are several tests available to help diagnose the underlying cause of infertility and develop an appropriate treatment plan.
One common test for diagnosing infertility in women is a blood test to check hormone levels. Hormones play a vital role in regulating a woman's menstrual cycle and fertility, and imbalances can indicate underlying issues. Hormone tests can help identify conditions such as Polycystic Ovary Syndrome (PCOS), thyroid disorders, or other hormonal imbalances that may affect fertility.
Another test that may be used to diagnose infertility in women is an ultrasound scan. This scan is typically performed transvaginally and allows the consultant to check the ovaries and uterus for any abnormalities. The scan can help identify issues such as ovarian cysts, fibroids, polyps or other structural factors that may be impacting fertility.
A Hysterosalpingo-Contrast Sonography (HyCoSy) is another test that may be used to diagnose infertility in women. This test involves injecting a special dye into the uterus and fallopian tubes to check for any blockages or abnormalities under direct ultrasound guidance. If there is a blockage in the fallopian tubes, it can prevent fertilisation from occurring, making it more challenging to conceive.
Other tests that may be used to diagnose infertility in women include laparoscopy, which involves inserting a small camera through a small incision in the abdomen to check for abnormalities, and a pelvic exam to check for any issues such as cervical polyps or fibroids.
It's important to note that infertility testing can be a lengthy and sometimes emotionally challenging process. However, early diagnosis and treatment can improve the chances of conceiving and carrying a healthy pregnancy. If you have concerns about your fertility, it is essential to speak ,to your consultant who can help guide you through the process of diagnosis and treatment. They can also provide support and advice throughout your fertility journey.
Infertility tests for men
In men, a semen analysis is usually the first test done to evaluate fertility. It involves testing a semen sample for sperm count, motility, and morphology. Additional tests may include hormone level tests, genetic testing, or ultrasound scans to check for problems with the reproductive organs.
Can you test infertility before trying to conceive?
Yes, it is possible to test for infertility before trying to conceive through preconception testing. This type of testing can help identify any underlying fertility problems that may affect a couple's ability to conceive. Preconception testing usually involves a range of tests, including hormone level checks and other medical tests to identify potential fertility factors.
For women, preconception testing may include a pelvic exam to check for any physical abnormalities that may affect fertility. Additionally, a blood test may be used to check for hormone imbalances, ovarian reserve or other conditions that may affect fertility, such as Polycystic Ovary Syndrome (PCOS). An ultrasound scan may also be used to check the ovaries and uterus for any structural abnormalities that could make conception difficult.
For men, preconception testing may include a semen analysis to check the quantity, quality, and motility of the sperm. A physical exam may also be conducted to check for any physical abnormalities that may affect fertility.
Overall, preconception testing can be a useful tool to identify and address any potential fertility problems before trying to conceive. If you are considering starting a family, it is recommended to speak with a healthcare professional to discuss preconception testing options.
How can I test myself for fertility?
Unfortunately, there are no reliable at-home tests for fertility. If you are concerned about your fertility, it is advisable to seek medical advice from a healthcare professional.
Fertility tests on the NHS
The NHS provides fertility testing for eligible individuals who have been trying to conceive for over a year or have a known medical condition that may affect fertility. These tests may include blood tests, ultrasound scans, and semen analysis for men. However, the availability of fertility testing may vary depending on your location and local NHS policies.
Private fertility testing
Private fertility testing is also available in the UK. Private fertility clinics may offer a range of tests and treatments, including blood tests, ultrasound scans, and semen analysis. It is important to research the clinic thoroughly and ensure that they are regulated by the Care Quality Commission (CQC).
Private fertility testing is a service available in the UK that provides individuals with the opportunity to undergo fertility tests outside of the National Health Service (NHS) system. Private fertility clinics typically offer a range of tests and treatments to help diagnose and treat fertility issues. These tests may include blood tests to check hormone levels, ultrasound scans to check for structural abnormalities in the reproductive system, and semen analysis to assess male fertility.
One of the advantages of private fertility testing is the convenience and flexibility it offers. Unlike the NHS, which may have long waiting times for fertility testing and treatment, private clinics can often provide appointments more quickly, allowing couples to start their fertility journey sooner. Additionally, private fertility testing may offer a wider range of testing options and treatments that may not be available on the NHS.
However, it is important to research private fertility clinics carefully before choosing one. Not all clinics may be regulated by the Care Quality Commission (CQC), which ensures that healthcare providers in England provide safe and effective care. It is important to ensure that the clinic you choose is reputable, experienced, and has a track record of success.
Private fertility testing can be expensive, and the cost of fertility treatment can vary depending on the clinic and the tests and treatments required. Some private clinics offer financing options or payment plans to help make treatment more affordable.
It is important to note that private fertility testing and treatment is not a replacement for seeking medical advice from your GP or a fertility specialist. It is recommended that couples who are experiencing difficulty conceiving should speak with a healthcare professional before undergoing any fertility testing or treatment, whether through the NHS or a private clinic. This ensures that any underlying medical conditions or issues can be identified and addressed, and that the couple receives the most appropriate care for their needs.
Infertility can be a challenging and emotional experience for couples trying to conceive. However, there are several signs and symptoms of infertility that can be identified, and tests are available to help diagnose and treat the underlying causes of infertility. It is important to seek medical advice if you have been trying to conceive for a year or more without success or if you have a known medical condition that may affect fertility. Remember, early intervention and diagnosis can significantly improve your chances of successful conception and a healthy pregnancy.
Author: Mr Osama Naji
Mr Naji provides advanced gynaecology scanning which is essential when conducting any gynaecology consultation, he is bilingual in English and Arabic and has an NHS base at the highly reputable Guy's and St Thomas' Hospital in London.
He is passionate about raising awareness of various subtle signs and symptoms of gynaecological conditions that are often overlooked by patients.
You can read more about Mr Naji on his about page here.