The first visit should include both partners and will probably include a complete medical history of both. The biology of conception , the possible causes of infertility and a plan to determine a diagnosis are all discussed at this time. The next step should be to establish an accurate diagnosis - that is , why pregnancy isn't occurring.

Males and females each account for 40 % of infertility , in the remaining 20 % either partners are responsible or the cause is unclear. In women , the main causes of infertility are ovulation disorders and tubal damages. The rarer causes are endometriosis , hormonal disorders , uterine and cervical factors and immunological problems. In men , the main causes of infertility are sperm abnormalities. We believe that thorough assessment of both partners should be made which includes a physical examination , and any blood tests and other investigations as appropriate. All patients entering treatment are asked to have a blood test for Hepatitis B and HIV ( AIDS ) screening. This is for the protection of yourselves and your potential child.

Male Investigation

The husband is usually asked to produce a semen sample for analysis in our laboratory. The Hamilton-Thorn Sperm Analyzer is a " state of art " computer using real time analysis for assessing motion characteristics of human sperm. The system is used to perform analysis not only routine assessment and actual IVF treatment samples , but also sperm as they are actually used for the micromanipulation techniques.

If there is any abnormality in sperm quality , additional blood test for hormone evaluation ( FSH , LH , Testosterone , Prolactin ) should be performed. In some cases of azoospermia ( no sperm founded in ejeculated semen ) , testicular biopsy is recommended.

Female Investigation

It may be recommended that you complete a monitored assessment cycle. This will give essential information regarding your hormonal profile ( FSH , LH , Prolactin , Progesterone and Estradiol ) and ultrasound scans allowing confirmation of ovulation. This can be combined with timed intercourse and a test of sperm survival within cervical mucus ( post-coital test ) performed 6 - 12 hours later.

Other investigations which are commonly required are

• A laparoscopy to assess the pelvic organs
• A hysterosalpingogram ( X-ray of the womb and tubes )
• A hysteroscope ( to look inside the womb )
• Transvaginal ultrasonography to assess the ovaries , uterus and endometrium
• Doppler ultrasound to measure blood flow to the uterus and ovaries.

In addition , vaginal and cervical swabs for pathogens may be requested for some women.