How to get a fertility test (2024)

I thought I would be pregnant by now. What should I do?

It depends how long you've been trying for a baby. Four out of five couples conceive within a year, provided they have regular sex and the woman is under 40. So if you've just been trying for a few months, it's worth waiting a little while longer (NHS 2017).

If you've already been trying for at least a year, you can make an appointment with your GP to discuss your fertility (NHS 2017). Because fertility tests and treatment can take time, see your GP sooner than this if you're over 35. There's also no need to wait if you already know or suspect that you have a health problem that could affect your fertility (NHS 2017).

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If possible, visit the GP together as a couple. Fertility problems affect men and women almost equally, and in 40 per cent of cases, there's an issue with both partners (CKS 2013), so it makes sense for you to get tested together (NHS 2017). If you're registered with different GP practices, you can make separate appointments, but you may each be asked to sign a form so that your GPs can share information (NHS nd).

Your GP may want to talk to both of you about your medical and sexual history, as well as your general lifestyle. She may also offer you a physical examination to check for some of the most obvious causes of fertility problems (NHS 2017). Depending on your GP, she may decide to refer you straight to a fertility specialist for these initial tests.

What will our GP want to know?

Your GP may ask you about:

  • Your health and medical histories. Certain health conditions and medications can affect your fertility.
  • Your sex life, including how often you have sex, how long you've been trying for a baby, and what kind of contraception you used in the past.
  • Your sexual health. This is because sexually transmitted diseases, such as chlamydia, can affect fertility.
  • Any sexual problems. Painful sex can be a sign of endometriosis or pelvic inflammatory disease. Erection or ejaculation problems can also cause problems with conception.
  • Any menstrual cycle problems, such as irregular periods.
  • Your reproductive history. For example, whether either of you already have children, whether you've been pregnant before, or whether you've had any miscarriages.
  • Your lifestyle and your partner's lifestyle, which includes things such as your weight and alcohol consumption, what kind of environment you work in, and whether you smoke or take drugs.
    (CKS 2013)

Your doctor will also discuss the implications of your age and your partner's age, as these can have an impact on fertility too (CKS 2013).

Having this kind of conversation with your GP may feel awkward at first. But it's always best to be completely honest, as this will mean you get the best possible treatment. Remember that your answers are confidential, and your doctor will have seen it all before. She's there to help you, not to judge you.

What fertility tests and examinations can our GP do?

Your doctor may offer you and your partner a physical check-up for obvious signs of a problem.

For women, your doctor may offer to examine your belly and pelvic area. This may reveal problems such as endometriosis, pelvic inflammatory disease, fibroids or ovarian cysts (CKS 2013, NHS 2017).

For men, your doctor may offer to check your penis and testicles for lumps or other issues (CKS 2013, NHS 2017).

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Depending on the answers to the questions your GP asks, and the results of your physical exam, you and your partner may also be offered some basic fertility tests.For women, these may include:

  • A cervical smear test, if you haven't had one recently (CKS 2013).
  • A blood test to check whether you are immune to rubella (German measles). A rubella infection during the first three months of pregnancy can cause birth defects in unborn babies (CKS 2017).
  • A blood test to check your immunity to varicella (chickenpox), which can cause problems for babies if caught for the first time in pregnancy (CKS 2017). This test may not be necessary if you've had chickenpox before, or been vaccinated against it.
  • A vaginal swab or urine test for chlamydia, a sexually transmitted infection that can cause damage to the fallopian tubes (CKS 2013, NHS 2017).
  • A blood test to check for the hormone progesterone, which shows whether or not you're ovulating. The test needs to be carried out at a particular point in your cycle. If you have irregular periods, you may also be offered a test for another ovulation hormone, gonadotrophins (CKS 2013, NHS 2017).

You may also be offered other tests, based on your symptoms. For example, thyroid problems can contribute to fertility issues, so if your GP thinks you could have a thyroid problem, she'll offer you an extra test to check for it (CKS 2013).

For men, initial tests may include:

  • a sperm test to check how many sperm you produce in each ejaculation, how healthy your sperm are, and how well they move (motility)
  • a urine test for chlamydia
    (CKS 2013, NHS 2017)

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If these test results don't reveal any specific problems, your GP may recommend a few lifestyle changes for you and your partner, and suggest you keep trying. If you're over 35 or the tests suggest any possible problems, your GP can make an appointment for you to see a fertility specialist (CKS 2013).

What happens once we're referred to a fertility specialist?

If you are referred, your specialist will ask you some more questions and offer you some more tests to try to get to the bottom of what's making it harder for you to conceive.

Many of the tests for women need to happen during a specific part of your menstrual cycle, so you may need to rearrange your diary to make time for them. For men, some tests may require that you don't ejaculate for a specified amount of time before the test (CKS 2013).

Tests for women may include:

  • A check to see if your fallopian tubes are clear, called a hysterosalpingogram (HSG). During this procedure, your doctor will inject dye through your cervix and use an X-ray to check for any blockages or any other problems, such as scar tissue and fibroids in your womb (uterus) (NHS 2017).
  • An ultrasound scan, where the radiologist gently inserts a small sensor into your vagina (transvaginal scan). In some cases, your doctor will also inject a dye into your womb, to look for any blockages in your fallopian tubes or abnormalities of your womb, including endometriosis and fibroids.
  • An operation to view your fallopian tubes, called a laparoscopy and dye. As above, your doctor will inject dye into your womb, but she'll then make a tiny cut in your stomach and insert a small probe containing a tiny camera. This will allow her to examine your womb, fallopian tubes and ovaries thoroughly. Although the procedure is fairly minor, it's more invasive than other tests, so usually only used if there is a strong suspicion that you have a problem, such as pelvic inflammatory disease (CKS 2013, NHS 2017).

Tests for men may include:

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  • A more detailed semen analysis to look for specific problems with your sperm, based on results from the previous analysis.

What are our chances of identifying our fertility problem?

Your fertility expert will work with you and your partner to try to find out why it's taking longer for you to conceive. Although most couples do get a diagnosis, it can sometimes be difficult to find out exactly why some have trouble conceiving.

For about 25 per cent of couples, fertility experts aren't able to say exactly what causes trouble conceiving (unexplained infertility). And for about 40 per cent of couples, an issue is found with both the man and the woman, which makes it hard to narrow it down to a single cause (NICE 2017).

If your fertility expert is able to find a reason for your fertility issues, she'll work with you to find the right treatment options for you. But even if she can't pinpoint a reason, you still stand a good chance of having a baby (Brandes et al 2011).

Many couples with unexplained fertility will conceive naturally if they keep trying (Brandes et al 2011). So your fertility expert may recommend that you try for a total of two years (including any time you were trying before having fertility tests) before recommending any treatment (CKS 2013).

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If you haven't conceived after two years of trying, and your fertility expert can't pinpoint a reason that it's taking so long, she may recommend in-vitro fertilisation (IVF) to help you conceive (CKS 2013).

Coping with the uncertainties, tests and procedures involved with infertility can be tough emotionally, so it may help to work out some positive ways to cope. Your GP or fertility specialist should also give you the option of counselling if you want it.

My partner won't get tested, what can I do?

Fertility testing can be intimidating for both of you. Some men are worried that, if they do have a problem, their partner will blame them for it. Reassure your partner that the problem could just as easily be with either or both of you (CKS 2013), and that whatever happens, it's no one's "fault".

Other men simply don't like the idea of having a physical check-up, or giving a sperm sample. Emphasise that your doctor will have seen it all many times before, and that any physical examinations will be done in a professional and private atmosphere.

When it comes to the sperm sample, your partner may be relieved to know that he can probably do it at home, provided the sample gets to the lab within about an hour. You could even offer to help, though your partner may prefer to do it in private.

Experts recommend that both of you get checked out (NHS 2017), and you may not be offered any treatment if you don't. Attending appointments together and giving each other plenty of moral support should help you both feel more comfortable. If your partner has a different GP, you can make separate appointments, but go along to both appointments together if you like. Your GPs will then share information to make sure you're getting the best possible care (NHS nd).

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If you or your partner is really reluctant to get tested, it may be worth considering counselling. Fertility testing and treatment can be an emotional process for you both, and a little extra support may make your journey easier. You can chat to others who are also trying for a baby in our actively trying support group.

You might also like:

  • Learn the most common causes of fertility problems.
  • Discover how age affects fertility in women and men.
  • Can stress make it more difficult for you to conceive? Find out.
  • If you already have a child, learn about secondary infertility.
How to get a fertility test (2024)
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