In general, a young and healthy couple may try naturally for 1-2 years before consulting a fertility specialist for review. However, the older woman (above 37 years) or those with symptoms suggestive of disorders of the reproductive system, should seek help earlier.
Significant symptoms include irregular menstrual cycles, painful menstruation, painful intercourse, painful defecation or chronic pelvic pain. Likewise, women with any pre-existing gynaecological conditions or hormonal disorders should also check with their gynaecologist regarding their ability to conceive naturally.
Pre-conception and fertility assessment may include the following:
- Full blood count and thalassemia screen
- Test of Rubella immunity (Chickenpox and Hepatitis B immunity tests can be done as well)
- Assessment of the woman’s egg reserve and ability to ovulate
- Integrity of the womb and its lining
- Patency of the fallopian tubes
- Status of the woman’s pelvis
- Sperm count
For selected couples, a detailed examination of the female pelvis with laparoscopy (keyhole surgery) may be recommended, especially if bedside examination reveals possible conditions that can be treated during laparoscopy surgery.