Infertility

Causes

There can be many reasons why you don't easily become pregnant. Only a third of those trying fall pregnant each month, although some of these will miscarry before they even know they're pregnant. The most common reasons include hormonal problems and blocked fallopian tubes in women, and a low sperm count in men.

What will your GP do?

Your doctor will want to know about your development as a teenager and your periods. He or she will ask when they started, how regular they are, whether you've ever been pregnant before or whether you've ever had a pelvic infection or sexually transmitted infection.

It's also important to mention any other illnesses you've had and any medication you may be taking. Your doctor will examine you, including internally, and send you for blood tests to check your blood count and hormone levels.

Your doctor may ask your partner about his development too, examine him and give him instructions to collect a semen sample for testing.

What can specialists do?

Once referred to a fertility specialist (called a reproductive medicine specialist), the cause of your infertility will be investigated. The treatment will depend on the cause and can range from hormone treatments to assisted conception techniques such as in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSE).

IVF and ICSE

IVF involves removing eggs from the woman's ovaries and mixing them with her partner's or donated sperm in a laboratory. A number of eggs are then placed back in the womb. This is a demanding treatment for the woman and there's a success rate of just 15 per cent. Many cycles may be required.

Access to IVF is limited on the NHS. However, from April 2005 couples should be entitled to one round of treatment. To qualify, women must be between 23 and 39 and have a specific fertility problem (eg, blocked fallopian tubes) or have failed to conceive for three years despite regular intercourse. A cycle of IVF at a private clinic costs around £2,000.

ICSE is sometimes recommended to those couples who have had no success with IVF. It involves injecting a single sperm into the egg. If a healthy embryo develops, it's then placed back in the womb as in IVF.

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• Pregnancy, Parenting & Baby Care
• Women's Health