GP Information

GP Resources

 

A Guide for GPs

At City Fertility, we understand that as a GP you are generally the first point of contact for patients with questions regarding their fertility. To help you provide your patients with the best possible understanding and guidance, we have put together some key information.

 

What is Infertility?

Infertility is defined as the inability to conceive after 12 months of unprotected intercourse. A normal fertile couple in their mid-20s, having regular sex, have a one-in-four chance of conceiving each month. This means that about nine out of 10 couples trying for a baby will conceive within a year. In addition, age plays an extremely important part as the fertility of a female will continue to decline significantly over the age of 35.

To put this into perspective:

  • 60 per cent of fertile people conceive within six months.
  • 80 per cent of fertile people will have conceived within the first year.
  • 95 per cent of fertile people, where the women are under the age of 35, will have conceived within two years.

 

Common Causes of Infertility

In recent years, the trend of delaying starting a family has led to increasing infertility rates, with age being the most common and significant fertility factor in females. However, a number of other factors can play a part in causing infertility, the breakdown being:

  • 30 per cent of infertility is due to female factors such as tubal or ovulatory problems.
  • 30 per cent is due to male factors such as problems with sperm quality or lack of sperm.
  • 30 per cent is due to a combined male and female factor.
  • 10 per cent remains unexplained.

 

Ovulatory problems may be indicated by irregular cycles. A way to determine whether this may be the cause of infertility is to confirm ovulation with a mid-luteal serum progesterone about seven days before the expected onset of menses.

 

Tubal problems may be caused by previous lower-abdominal operations, IUD usage, PID or lower-abdominal pain. However, tubal problems may also be asymptomatic, such as chlamydia.

 

Semen problems may be caused by childhood hernia operations, orchidopexy, adult mumps or constant exposure to toxic substances. However, most have no predisposing factors or are genetically determined. In circumstances associated with semen problems, it is advisable to arrange a semen assessment.

 

When to refer to a fertility specialist

You should refer a person to one of our specialists if the patient has the following:

  • No success after 12 months of unprotected sex for women aged under 35, and six months for women over 35.
  • Indicated PCOS.
  • Irregular cycles.
  • Endometriosis or a history suggestive of tubal damage.
  • Recurrent miscarriage (two or more consecutive pregnancy losses).
  • Premature menopause.
  • Poor semen quality.
  • Genetic conditions such as Turner syndrome, cystic fibrosis and Klinefelter syndrome.

 

Oncology patients

Oncology patients should be referred as soon as possible, before treatment begins, to enable us to give them the best chance of future fertility. Cryopreservation of sperm, eggs or embryos provides them with a more optimistic prognosis.

 

Fertility management after vasectomy or tubal ligation

If patients have undergone a vasectomy or tubal ligation, City Fertility Centre can provide treatments to achieve a pregnancy. Surgical aspiration and microinjection of sperm (ICSI) offers an alternative to vasectomy reversal, and standard IVF treatment offers an alternative to female sterilisation reversal.

 

Counselling

City Fertility Centre has a counselling service accessible to outside referrals (at no cost to the patient) for specialised infertility advice and support.

 

Private Health Insurance

It is not necessary for patients to have private medical insurance for an appointment or treatment at any of our units.

 

Patient Resources

We offer a range of support services and information to assist your patients in their fertility journey.

They can access information and support via:

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