While some couples fall pregnant easily, many struggle to start a family. This can be frustrating and heartbreaking. Plus, many couples are reluctant to seek help because the magic of trying for a baby suddenly becomes so clinical.

An infertility investigation is often the next step. It’s not an easy decision but sometimes it becomes the only option. Here’s what to expect.

When should you seek help?

If you do not have any underlying medical condition that could be affecting your chances of falling pregnant, the rule of thumb is as follows:

• Women under 35 have a 75% chance of falling pregnant in one year, so if after a year you have still not conceived, you may need to see a doctor.
• Women over 35 have a 66% chance of falling pregnant in one year. It’s recommended that you consult a doctor after six months if you have not conceived.
• Women over 40 have a 44% probability of pregnancy in one year. Because it becomes more dangerous each year after 40 to conceive a child, you should consult with your doctor before trying to make sure that you are not at any risk.

What gets investigated?

Ovulation

Ovulation is hugely important because you can’t conceive without producing a healthy egg. An ovarian reserve test may be done via a blood test (to see your supply of eggs) and imaging tests may be done on the ovaries. An ultrasound may be done to see when ovulation will occur by viewing any changes in the follicles (which form inside an ovary when an egg is produced). Your hormone levels will be tested too.

Anatomy

The other part of the examination will make sure that there are no physical problems with your reproductive system, such as blockages in the fallopian tubes, or if the lining of your uterus allows the egg to easily attach. Various imaging tests may be done, such as ultrasounds and specialised X-rays.

Sperm

For the men a simple sperm test is done to check the amount of sperm that is produced and if the sperm moves as fast as they should. Blood tests may also be done to see hormone levels. Should they be slower than normal, artificial insemination might be the answer.

In most cases, an infertility investigation can find and solve the problem, but in some cases it may not be enough. In these cases, IVF (in vitro fertilisation) could be the best solution. It’s expensive but it has seen many struggling couples realise their dream of having children.