How is fertility tested for and treated?

Not being able to fall pregnant can be upsetting and difficult to deal with. If your doctor suspects there is a reason you cannot get pregnant, there are a number of tests that can be done to determine you and your partner’s fertility. Depending on what the fertility tests show, there are a number of treatments available to both of you. Treatment for infertility can bring hope to people wanting to have a baby, but it also has physical, emotional and financial costs. And success is not guaranteed.

What are the types of fertility tests?

You and your partner will both need tests to work out why you can’t get pregnant. Sometimes, the problem lies with the woman. Sometimes with the man. Sometimes with both. And sometimes, the reason is never found. Your doctor can refer you for fertility tests, which will usually happen in hospital or at a fertility clinic.

Sperm test

In about 2 in 5 cases, fertility problems are due to the male partner. Sometimes fertility problems are because there are not enough sperm or the sperm are not moving properly.

Your doctor can arrange a sperm test. The male partner will be asked to give a sperm sample and take it for testing, probably at your local hospital or a pathology laboratory.

Blood tests to check ovulation

The levels of hormones in a woman’s blood are closely linked to ovulation, when the ovaries release an egg into the fallopian tubes. Hormone imbalances can cause ovulation problems, and a blood test can help see whether this is happening.

Going through a phase of not having periods or having irregular periods, can also be signs of ovulation problems. The most common reason for ovulation problems is polycystic ovary syndrome.

Test for chlamydia

Chlamydia is the most common sexually transmitted infection STI in Australia. It can cause pelvic inflammatory disease and fertility problems. Your doctor can refer you for a test for chlamydia. This can be a urine test or a swab from the urethra (the tube from which urine/wee passes) or the neck of the cervix.

Ultrasound scan

An ultrasound scan can be done to check the woman’s ovaries, womb (or uterus) and fallopian tubes. With a transvaginal ultrasound scan, a small ultrasound probe is placed in the vagina. This scan can help doctors check the health of your ovaries and womb.

Certain conditions that affect the womb, such as endometriosis and fibroids, can prevent pregnancy from occurring. The scan can also check for blockages in your fallopian tubes (the tubes that connect the ovaries and the uterus), which may be stopping eggs from travelling along the tubes and into the uterus.

X-ray of fallopian tubes

This is called a ‘hysterosalpingogram’ (HSG). A dye is injected through your cervix while you have an x-ray. The dye will help your doctors to see if there are any blockages in your fallopian tubes. Blockages can stop eggs moving down the tubes to the womb and stop you getting pregnant.

Laparoscopy

If you have a known pelvic problem such as pelvic inflammatory disease (PID) or endometriosis, or your doctor suspects you might, laparoscopy (keyhole surgery) may be done. This involves making small cuts in your abdomen (tummy) so a thin tube with a camera (laparoscope) can be used to look at your uterus, fallopian tubes and ovaries.

What infertility treatments are available for women?

Fertility treatments usually aims to either fix your infertility issue or use an assisted reproductive technology like IVF to help you have a baby.

The treatment options depend on your cause of infertility. Treatments vary in how much they cost and how effective they are.

Treatments include:

• Hormone medications like clomiphene (a tablet called Clomid) can help stimulate ovulation.
• Surgery can treat a blocked or damaged fallopian tube(s).
• Surgery, laser treatment or medicines can treat endometriosis or fibroids.
• Intrauterine insemination (IUI, also called artificial insemination) is the placement of sperm directly into the uterus.
• In vitro fertilisation (IVF) is a well-known form of pregnancy treatment, where eggs are collected from a woman’s ovaries, and sperm from a man, and used to create an embryo (fertilised egg) in a laboratory. The embryo is then placed into the woman's uterus (womb).
• Intracytoplasmic sperm injection (ICSI) is a type of IVF and involves the injection of a single sperm into an egg in a laboratory.

What infertility treatments are available for men?

The treatment options depend on your cause of infertility. Treatments vary in how much they cost and how effective they are.

Treatments include:

• Sperm retrieval (collecting sperm) for use in assisted reproductive treatments like timed artificial insemination
• IVF with the male partner’s sperm
• ICSI (see section above)

Eating a healthy diet and avoiding alcohol and cigarettes can help with improving sperm quality.

What other fertility options are available?

Donor conception may be another option to achieve pregnancy. Donor sperm, donor eggs, or donor embryos can all be used to help you become pregnant.

People who can’t get pregnant may also consider surrogacy or adoption.