A couple-centred fertility assessment that looks at ovulation, age, uterus, fallopian tubes and sperm factors—then explains which next step is proportionate, time-aware and realistic.
Infertility is commonly defined as not achieving pregnancy after 12 months of regular unprotected intercourse. Evaluation is usually advised after six months when the female partner is 35 or older, and sooner after 40 or when a known concern makes waiting unhelpful.
Earlier review is also sensible with absent or very irregular periods, suspected endometriosis or tubal disease, repeated pelvic infection, previous chemotherapy, sexual difficulty or a known semen concern. Recurrent pregnancy loss is a different clinical problem and deserves its own assessment.
A finding is important only when it explains the couple’s situation or changes treatment. Common scans and blood tests can show variations that are not the true cause.
PCOS, thyroid or prolactin conditions, reduced ovarian function and changes related to age can make ovulation infrequent or affect egg availability.
Cycle history and targeted testing help distinguish ovulation from ovarian-reserve concerns.
Previous pelvic infection, tuberculosis in selected settings, endometriosis or pelvic surgery can damage or block the tubes.
Tubal-patency testing is chosen according to history and whether results will change treatment.
Fibroids, polyps, scar tissue, congenital uterine differences, adenomyosis and endometriosis may affect implantation or fertility in some people.
Not every finding causes infertility; its size, site and symptoms determine relevance.
Low sperm number or movement, abnormal form, obstruction, ejaculation difficulties, varicocele, illness, medicines or prior cancer treatment may contribute.
Semen analysis belongs early in a couple assessment and an abnormal result often needs confirmation.
Infrequent intercourse, uncertainty about the fertile window, erectile or ejaculation difficulty and selected medicines can reduce the chance of conception.
These are medical topics, not personal failures, and should be discussed without embarrassment.
Sometimes standard evaluation shows ovulation, patent tubes and an acceptable semen result without identifying why pregnancy has not occurred.
“Unexplained” does not mean imaginary; age and duration help determine observation or treatment.
A staged assessment answers whether ovulation occurs, sperm is available and functional, the uterus can support pregnancy and at least one tube is usable when natural conception or IUI is planned.
Tests are selected from the history and previous results. A single AMH value, scan or semen result should not be treated as a complete fertility diagnosis.
Pregnancy history, duration of trying, cycle pattern, intercourse timing, illnesses, surgery, infections, medicines, tobacco or alcohol exposure and family history are reviewed together.
Cycle history may be sufficient to suggest ovulation; hormone tests and ultrasound are selected when they answer a question. Ovarian-reserve tests estimate response to stimulation better than natural pregnancy by themselves.
Pelvic ultrasound examines the uterus and ovaries. HSG, sonographic tubal testing, hysteroscopy or laparoscopy may be considered according to symptoms and earlier findings—not all at once.
A properly collected semen analysis evaluates concentration, movement and form. One abnormal result may need repeat testing and male-factor findings can require andrology or urology input.
Age, duration, diagnosis, previous treatment, finances and preferences determine whether to continue trying, use simpler treatment or refer promptly for assisted reproduction.
Dr. Shilpa Jaypuriya provides initial couple assessment, cycle and ovulation review, pelvic evaluation, treatment of appropriate gynaecological or hormonal contributors, and preconception guidance. Semen testing, tubal evaluation, surgery, IUI, IVF, ICSI or donor treatment is coordinated or referred when indicated and available.
We do not present every couple as an IVF case. We also do not allow repeated low-benefit treatment to consume time when age or diagnosis makes specialist assisted reproduction more appropriate.
Enquire privately on WhatsAppFertility benefits vary widely and assisted reproduction is frequently excluded. Request written estimates for medicines, monitoring, laboratory procedures, anaesthesia, freezing and storage where relevant. JEWCC can provide available clinical documentation; insurer approval remains external.
A common threshold is after 12 months of regular unprotected intercourse when the female partner is under 35, and after 6 months from age 35. Seek earlier advice after 40 or with very irregular periods, known tubal or endometriosis concerns, prior cancer treatment or a known male-factor issue.
Yes. Infertility can involve female, male, combined or unexplained factors. Parallel assessment saves time and reduces unfair blame.
No. AMH mainly helps estimate ovarian response to stimulation and must be interpreted with age and the wider evaluation. It cannot by itself predict whether an individual will conceive naturally.
No. Depending on the cause and time available, options can include expectant management, timed intercourse, ovulation induction, treatment of a specific condition or IUI. IVF is appropriate for selected indications.
Stress can affect wellbeing, relationships and sometimes sexual frequency, but infertility should not be dismissed as “just stress.” Medical evaluation and emotional support can proceed together.
Many policies exclude infertility evaluation and assisted reproduction, while some cover limited investigations or treatment for an underlying condition. Confirm written policy terms and authorisation directly with the insurer or TPA.
