Diagnosis, treatment and services

Fertility is the ability to conceive and have children. It depends on many factors, including nutrition, sexual behavior, endocrinology (hormones) and lifestyle.

Infertility can be caused by male or female factors or by a combination of factors, and sometimes no cause can be identified.

Private patients and eligible NHS patients have the option to be diagnosed and treated at the Complete Fertility Centre Southampton

Diagnosis

We carry out several tests and investigations to find out why a couple has been unable to conceive and to guide our recommendations for which treatment option is best.

Women may have a number of tests including:

  • blood tests. These are used to check for infections and immunisations, such as rubella. They also check levels of various hormones in the blood including follicle stimulating hormone (FSH) luteinising hormone (LH) and progesterone, to help us diagnose any problems with ovulation and the woman's egg supply, and work out the size of dose for any stimulation drugs we might prescribe.
  • pelvic assessment. This is an ultrasound scan of the pelvis, which is where the womb and other reproductive organs are located. It enables us to check for problems such as fibroids or polyps.
  • hysterosalpingography (HSG). Dye is injected through the cervix (neck of the womb) and then an X-ray of the uterus and fallopian tubes can be taken. The dye helps the internal organs show up on the X-ray and show up anything that is not normal.
  • hysterosalpingo-contrast sonography (HyCoSy). A vaginal ultrasound probe is used to enable the doctor to examine the womb and fallopian tubes.
  • laparoscopy and dye test. A thin bendy microscope is inserted through a small cut in the abdomen, so that the doctor can look at the womb and fallopian tubes. A dye can be injected through the cervix to see if it runs through the fallopian tubes.

Some of these tests need to be done at a particular time in your menstrual cycle. You will be told about this and any other requirements when the test is booked.

Men may undergo a number of tests including:

  • sperm analysis. A sample of semen is examined to check the quality and quantity of sperm. This includes the sperm count – the number of sperm in a milliliter of semen - sperm motility (movement) and morphology (size and shape). You will be provided with information about how to prepare for this test when your appointment is arranged.
  • blood tests. These are used to check hormone levels in the blood, including follicle stimulating hormone (FSH) luteinising hormone (LH) and testosterone. They are used to help identify and work out the causes of problems with the male reproductive system.
  • DNA test. Analysis of the chromosomes (your genetic make-up) is carried out to look for markers (genetic signs) of conditions such as Y micro deletions or cystic fibrosis. This analysis helps us spot conditions that could be causing your infertility as well as conditions that may affect any children that are conceived from your sperm.

Once the investigations have been carried out, we should be able to identify the problem and be able to tell whether we can help the couple conceive.

Treatment

The diagnostic tests and investigations determine which treatment options are appropriate. We aim to help each couple to decide which option would be best for them and to allow them to stay in control of the process by laying out their own timeline for treatment.

Treatment options include:

  • natural cycle follicle tracking. A series of ultrasound scans is used to measure the follicles in the ovaries and track the growth and release of an egg. It can be used to predict the best time in a woman's cycle to try to conceive.
  • ovarian induction. Drugs are given to a woman to artificially stimulate the development and release of mature eggs, usually in greater numbers than the normal single egg per cycle. By increasing the number of eggs that are available for fertilisation, this treatment can help increase the chances of conception naturally or with assistance.
  • intra-uterine insemination. In this procedure a sample of healthy sperm is inserted directly into the woman's womb. This gives the sperm more chance of traveling to the fallopian tubes and fertilising an egg.
  • IVF (in vitro fertilisation). During IVF, eggs are removed from the ovaries and fertilised with sperm in a laboratory dish before being placed in the woman’s womb.

Treatment is supported by advice on getting pregnant and regular check-ups at the unit.

Our services

We run a number of clinics and other fertility services and work together with colleagues in other gynaecological specialties to provide coordinated, joined-up care.

Our services include:

  • dedicated fertility clinics running five days a week, seeing 70-80 patients each week
  • a monthly clinic for recurrent miscarriage
  • a monthly combined endocrine (hormone) and reproductive medicine clinic for women with both endocrine and fertility problems, such as polycystic ovarian syndrome
  • weight management clinics run by the fertility counsellor
  • specialist andrology (male) services including the regional referral service for male fertility problems
  • joint regional endometriosis and fertility service.