It’s very common to find it difficult to get pregnant. In fact, 9% of the global population will also have problems conceiving.²

There are many factors that could be causing your infertility and so you shouldn’t focus on whose ‘fault’ it is.

Once you and your partner have undergone fertility tests, your doctor will diagnose what’s causing your fertility problems.

Unfortunately, sometimes there is no clear factor and you may be diagnosed with unexplained infertility. In this case, your doctor may recommend undergoing more advanced fertility treatment – ART treatment.

Female age

As you get older, your fertility begins to decline
A healthy 30-year-old woman has around a 20% chance of conceiving each month³
However, a 40-year-old woman has less than a 5% chance of conceiving each month³
It becomes more likely that you’ll need to undergo ART treatment in order to conceive

Ovulation problems

These account for around 25% of fertility difficulties⁴
Each month, your ovaries must release a healthy egg (ovulation) in order to conceive
If you have irregular or absent periods, are overweight or underweight, you may not be ovulating
Ovulation problems can usually be treated with medication⁴

Blocked fallopian tubes⁵

Tubal disease accounts for between 25% and 35% of female infertility⁶
Your fallopian tubes are very delicate and can easily become blocked or damaged
Blockages can be caused by scarring from a previous infection or previous abdominal surgery
This can prevent sperm from reaching your egg, and interfere with an embryo’s development and its implantation into your uterus lining
Blocked fallopian tubes may be treated with surgery, or you may need to undergo in vitro fertilisation (IVF)

MYTH: Taking contraceptive pills for several years increases chances of infertility.

TRUTH: Studies have not shown a link between infertility and using the pill for a long period of time.

Like many women, you may have used the contraceptive pill for several years to carefully avoid an unwanted pregnancy. When you’re ready to conceive, it’s understandable to feel cheated if you don’t get pregnant immediately.

However, studies haven’t shown a link between infertility and using the pill for an extended period of time.¹³

So while the unknown is frustrating, you shouldn’t worry that you should have stopped using contraception earlier.

Discovering that you may be infertile can be hugely distressing. Feeling overwhelmed about your future is completely normal and you may need extra support from those close to you.

What fertility tests will be performed initially?

If you visit your family doctor first, they may conduct some simple and less invasive fertility tests. These may include:

• General physical examination
• Weight check
• Pelvic and genital examination
• Breast exam
• Routine cervical screening (smear) test
• Blood tests

Afterwards, you and/or your partner may be referred to a fertility specialist if there is a need for further or more invasive tests.

What are fertility doctors testing for at the clinic?

Your fertility doctor will check that you and/or your partner have:

• The right balance of hormones to help eggs to mature
• Regular ovulation
• A healthy, functioning uterus and intact fallopian tubes
• A thick uterus lining that could nourish an embryo
• Who performs the fertility tests at the clinic?

Your fertility team is made up of a range of doctors and fertility nurses, along with specialists such as reproductive endocrinologists and embryologists, who oversee more complex treatments such as in vitro fertilisation (IVF).

Ask your doctor or fertility team in the clinic about their different roles and how they will be supporting you.

Preliminary tests^1,2

Personal history — You will be asked about your medical history and sex life in detail. If you feel uncomfortable discussing anything in front of your partner, ask to speak with your doctor in private
Physical exam — You may have a pelvic examination to check the shape and size of your uterus. Your breasts may also be examined physically, and your weight and body mass index (BMI) measured
Cervical screening (smear) test — You may be asked about your most recent cervical screening test or a new test may be performed. This helps to rule out any infection or abnormal cells on your cervix
Screening blood and urine tests — You will have some routine and some investigational blood and urine tests. Please ask your fertility clinic about the tests that will be done
General health tests — You may be tested for rubella (German measles), chlamydia, hepatitis B and C, and human immunodeficiency virus (HIV). Depending on your heritage, you may also be tested for diseases or disorders that are more common amongst certain ethnic groups, such as sickle cell anaemia or thalassaemia

Regular monitoring

Hormone blood and urine tests — These tests will be taken on specific days of your menstrual cycle to measure different hormone levels.² These will help to determine if you are ovulating,^2,3 as well as the quality and quantity of the eggs produced (your ovarian reserve).4 This can help predict the ovary’s response to IVF treatments
Temperature — Your temperature may also be taken throughout the menstrual cycle to identify when you are ovulating³

Antral follicle count (AFC) — This test uses an internal ultrasound scan to show the number and size of follicles present in the ovaries²
Hysterosalpingogram (HSG) — This test applies a coloured dye inside the uterus to check the shape and size of uterus and fallopian tubes. It will also show the doctor if there are any tubal blockages or cysts⁵
Laparoscopy — This test involves insertion of a small surgical telescope into the abdomen, under general anaesthetic.5 This can check for any blockages, growths or signs of endometriosis around the uterus and fallopian tubes⁵