Primary infertility investigations

Sub-fertility is very common problem affecting about 1 in 8 couples. This can be defined as “primary” i.e. no previous pregnancies or “secondary” the woman has had a previous pregnancy, even if this ended in a miscarriage. Most gynaecologists would not investigate sub-fertility until the couple have being trying to conceive for 12 months without success.

Sub-fertility causes can simplistically be divided into 4 categories. Ovulatory problems, tubal factors, male factors and “unexplained”. A basic history and examination including a vaginal ultrasound should be undertaken. Other basic investigations namely blood tests; a HSG or hysterosalpingogram (a dye test to check if the fallopian tubes are blocked), semen analysis and sometimes a laparoscopy should be performed before the patient is referred onto a tertiary fertility centre.