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The first step on this journey is to determine the cause of infertility that a couple is facing. Each patient presents with an individual set of circumstances and requires a thorough investigation to discover the root cause of the problem. According to the Infertility Awareness Association of South Africa 40% of infertility is due to male factor, 40% is due to female factor and 20% is both male and female or due to an unknown cause.
Upon your first visit your medical history will be discussed and a fertility status evaluation will be performed on both the male and female partner. For female’s ovarian reserve testing, through blood tests evaluating Anti Mullerian Hormone levels or day 2/3 Follicle Stimulating Hormone levels, is performed to establish the ovarian reserve (number of eggs present). A Hysterosalpingogram can be performed to determine tubal function or uterine abnormalities to ensure that there is no blockage and that an ovulated egg is able to be reached by sperm. If tubal disease or endometriosis is suspected, more invasive procedures such as a Hysteroscope and Laparoscope may be required. For males a basic semen analysis will be performed to determine if sperm are being produced, how much sperm is being produced and the quality of the sperm being produced. If no sperm are found in a semen sample then testosterone levels may be tested as this is the key hormone in sperm production or another semen analysis paired with urine analysis may be performed to rule out retrograde ejaculation, which may be preventing sperm from successfully being ejaculated through a blockage. If disorders such as a varicocele or hydrocele are suspected then referral to a Urologist to address these issues will be suggested before fertility treatment continues. Lastly, a testicular biopsy could be performed to determine if sperm are present in the testicles.
Once the fertility status evaluation is successfully completed the best procedure to assist you in falling pregnant will be determined and conveyed to you along with a timeline.