Support and advice from a GP/Gynaecologist is the first step in managing of infertile patients . Normally, referral should take place after two years of initial infertility treatment from a GP or gynaecologist .Therefore referrals should be addressed to an expert fertility consultant.
Initially GP/gynaecologist is identified as being a factor in the couples infertility. Relevant information to be included in the referral letter:
- Menstrual history
- Medical history
- Previous pregnancies
- Frequency & timing of sexual intercourse
- Lifestyle factors
- BMI
Appropriate investigations carried out prior to referral will allow more information to be given to the couple at their first consultation. IVF/ICSI assisted conception treatment is provided within 12 months of being placed on the treatment waiting list and patients cannot be added to the waiting list until all the investigations and consents have been completed. Early investigations should speed up the pathway for fertility treatment. Waiting times vary due to demand over the year. Investigations are as follows:
- Rubella screening
- Chlamydia screening – female
- Serum TSH
- Blood sugar testing
- Hormone levels – Day 2 or 3 FSH & Oestradiol of cycle if regular cycle
- Random FSH, LH, Oestradiol, Prolactin if irregular/ infrequent periods
- Ovarian reserve testing- AMH
- Semen analysis (if available)
If semen analysis shows azospermia examination of the male as well as blood tests – hormones (FSH, LH, testosterone, prolactin) and male karyotype would be done.