Difficulties Conceiving
Dr Mairaed Crawford
Trigger warning: infertility, difficulties with conception.
Fertility describes the human body’s ability to produce a child. There are many factors that affect both female and male fertility – age, lifestyle choices such as smoking and alcohol consumption, medical illnesses, certain medications, being under/overweight. Without recounting the story of the birds and the bees, the process needs a healthy egg to be penetrated by a healthy sperm, and for that fertilised egg to implant into the lining of the uterus.
With a wealth of knowledge around sexual and reproductive health amongst our team, the GPs consulting at Neighbourhood Medical are well-placed to guide our patients through fertility issues.
We are also able to support individuals and couples experiencing ‘social infertility’ or who are considering delaying conception (i.e. considering ‘egg freezing’ by working through each aspect in a step-wise way, including:
1. Optimising your health in preparation for pregnancy
People/couples hoping to conceive should see their GP 3-6 months prior to conception, to allow their doctor to complete a comprehensive history and assessment, in order to optimise fertility factors and help support a healthy pregnancy. This consult usually involves:
- taking a comprehensive medical/lifestyle history to assess smoking, alcohol and drug use, weight, prescription medication use, immunisation status, exposure to possible occupational risks
- arranging for appropriate testing (ensuring protection against certain illnesses, screening for STIs, discussion of screening for genetic conditions)
- ensuring preventative health testing is up to date
- discussing timing of intercourse
- initiating pre-conception vitamins
- flagging any potential issues with fertility and making a plan for an appropriate time-frame for ‘trying to conceive’ based on individual factors
2. Assessment if you/your partner are having difficulties conceiving
.‘Infertility’ is typically defined as an inability to conceive after at least one year of regular, unprotected sex. Infertility affects 15-20% of couples trying to conceive. The health of both male and female partners are important considerations in assessing infertility, with male factors for infertility being identified in up to 50% of couples who fail to conceive.
During a consultation for infertility, as well as addressing the above points in terms of health optimisation, sexual function and timing of intercourse, your GP will take a deep dive into understanding you/your partner’s health to start looking at possible causes for infertility. Causes of male and female infertility are wide and varied and can include anatomical & genetic conditions, systemic illness, infections, trauma and injury caused by operations or treatments for specific illnesses.
Your doctor will may perform an examination looking for an indictors of underlying causes of infertility, and will then arrange for investigations. For males this typically includes bloods to assess hormone function and a semen sample to assess quality and function of sperm. For females this encompasses bloods to assess hormone function, screening for STIs (which can affect fallopian tube function) and a pelvic ultrasound to assess uterine and pelvic anatomy; looking for clues of underlying conditions that may affect fertility such as fibroids, PCOS and endometriosis.
3. Arrange referral for treatment for infertility
After a comprehensive assessment to seek out the possible causes of infertility, the GPs consulting at Neighbourhood Medical can then arrange for appropriate referral to trusted fertility specialists who can assist in further investigation/specific treatments for infertility.
We recognise that investigation and treatment for infertility can take a large toll on your mental and physical wellbeing. Once you have been referred on to a specialist, your GP will continue to support your/your partner’s physical and emotional health throughout your fertility journey.
Here are some excellent resources to help you and your partner better understand infertility.
Monash IVF ‘Your fertility’https://monashivf.com/understanding-fertility/your-fertility/
Healthy Male ‘Male Infertility’https://www.healthymale.org.au/mens-health/male-infertility
Resources:
1. https://www.jeanhailes.org.au/health-a-z/fertility-pregnancy/fertility#protecting-fertility
2. https://www.racgp.org.au/getattachment/fd844ce0-7f88-4d2a-872d-d796d24d7d63/attachment.aspx
3. https://www1.racgp.org.au/ajgp/2020/june/female-fertility-in-general-practice-setting
4. https://www.racgp.org.au/afp/2017/september/male-infertility
