screening for fertility

Overview

Fertility screening is a set of tests and conversations that help check how well your body can get pregnant and carry a pregnancy. It is not a treatment, but a way to understand your reproductive health. A doctor or fertility specialist may do blood tests, ultrasound scans, and ask about your health history to see if there are any issues that could make it harder to conceive.

Fertility screening is common. Many women and couples seek it when they have trouble conceiving. Around 1 in 7 couples in the UK experience difficulty getting pregnant, so fertility screening is a standard part of care when pregnancy does not happen as expected.

Fertility screening is for women of reproductive age who are trying to get pregnant. It may also be suggested if you have irregular periods, a known gynecological condition, or a partner with a low sperm count. Women over 35 may be offered screening earlier than younger women.

Symptoms

Common symptoms

• Irregular or absent menstrual periods
• Very painful periods that affect daily life
• Severe pelvic pain or pain during sex
• Hormonal signs such as acne, facial hair, or thinning scalp hair
• Unusual vaginal bleeding between periods

Symptoms in children

• Fertility screening is not usually performed in children. But early signs of hormone problems or very early puberty might sometimes be assessed, and parents should talk to a pediatrician if they have concerns.

Symptoms in older adults

• For women over 35, it is normal for fertility to decline naturally. You may be offered screening sooner if you are over 35 and have been trying for 6 months. Symptoms like irregular periods or discomfort can still be signs worth checking.

Causes

Main causes

• Problems with ovulation, such as polycystic ovary syndrome (PCOS) or hormonal imbalances
• Blocked or damaged fallopian tubes, often from infection or surgery
• Endometriosis, a condition where tissue similar to the womb lining grows elsewhere
• Uterine problems like fibroids, polyps, or scar tissue
• Age-related decline in egg quantity and quality

Risk factors

• Age over 35
• Smoking or heavy alcohol use
• Being underweight or overweight
• Having past pelvic infections, including sexually transmitted infections
• Previous surgery on the abdomen or pelvic area
• A family history of early menopause or fertility problems

When to see a doctor

See a doctor urgently if:

• If you have severe pelvic pain, heavy bleeding, or signs of infection, see a healthcare provider the same day or call emergency services if symptoms are sudden and severe.

Book a routine appointment if:

• If you are under 35 and have been trying to conceive for 12 months without success
• If you are 35 or older and have been trying for 6 months without success
• If you have irregular, missing, or very painful periods
• If you have been diagnosed with a condition that could affect fertility
• If you have had previous abdominal or pelvic surgery

Diagnosis

Fertility screening is a step-by-step process. Your healthcare provider will talk with you about your medical history, periods, lifestyle, and any pregnancies you have had. You will also have a physical exam, and then specific tests may be arranged over the next few weeks.

Tests that may be done

• Blood tests to check hormone levels and egg supply
• Pelvic ultrasound to look at the uterus, ovaries, and fallopian tubes
• A test to see if your fallopian tubes are open, sometimes called an HSG (hysterosalpingogram) or a saline ultrasound
• A mid-cycle blood test to confirm if you are ovulating
• A sexual health check for infections that can affect fertility

What to expect at your appointment

The process usually takes a few weeks. Blood tests are simple, and ultrasound is painless. The fallopian tube test may cause mild cramping for a few minutes. You can usually return to your normal routine afterwards. Your doctor will explain each step before it happens and give you time to ask questions.

Treatment

If screening finds a fertility issue, there are many treatment options. Treatment depends on the cause, your age, and your overall health. For many people, lifestyle changes and simple medical approaches are enough. Others may need more advanced help like assisted reproductive technology.

Self-care at home

• Track your menstrual cycle and ovulation to learn your fertile days
• Stop smoking and reduce or stop alcohol
• Reach and keep a healthy weight for your body
• Reduce stress through relaxation, counseling, or gentle exercise

Medical treatments

Medications are often used to encourage ovulation or regulate hormones. Some are taken by mouth, and others are given as injections. These treatments are tailored to your specific situation. Your healthcare team will explain the options, how to take the medicine, and what to expect. Always follow your provider's instructions.

When is surgery considered?

Surgery may be an option if you have blocked fallopian tubes, fibroids, endometrial polyps, or endometriosis. Surgery can remove growths, open blocked tubes, or repair pelvic organs. Your specialist will talk with you about whether surgery is likely to help and what it involves.

Living with this condition

Fertility screening can feel stressful because results may take time. Try to keep a routine, attend appointments together with your partner if possible, and stay informed by asking questions. You can also give yourself permission to take breaks from thinking about fertility when you need to.

Lifestyle tips

• Get enough sleep and keep active in ways you enjoy
• Limit caffeine and avoid tobacco and recreational drugs
• Find ways to cope with stress, such as deep breathing, walks, or creative activities
• Talk openly with your partner, friends, or a counselor about how you're feeling

Diet and exercise

Eat a balanced diet rich in fruits, vegetables, whole grains, and healthy proteins. Take folic acid as advised by your doctor, even before pregnancy. Moderate exercise like walking, swimming, or cycling is helpful, but avoid extreme workouts that may disrupt your cycle.

Mental health and emotional wellbeing

Going through fertility checks can bring up feelings of sadness, frustration, guilt, or anxiety. These feelings are normal. It can help to talk about them, and many people benefit from professional support. Do not feel you have to handle this alone.

Prevention

Not all fertility problems can be prevented, because some causes are genetic or age-related. However, you can lower your risk by staying sexually healthy, protecting yourself from infections, maintaining a healthy weight, and not smoking.

Vaccines

Some vaccines can protect against infections that might affect fertility, such as the HPV vaccine, which helps prevent cervical cancer. Talk to your doctor about recommended vaccines for your age and health.

Screening programmes

Regular gynecological check-ups and screening for sexually transmitted infections are important. If you have concerns about your fertility, you do not have to wait — asking your doctor earlier is always allowed.

Complications

If left untreated

• If you do not seek help, an underlying cause may not be found, and time may pass, making it harder to conceive naturally as you get older
• Conditions like endometriosis or pelvic infections can sometimes worsen without treatment
• You may miss out on options that require starting treatment early

Long-term outlook

The outlook is hopeful. Many people who have fertility screening find no major problem and go on to conceive naturally. For those who do find an issue, there are effective treatments today. Even when conception is difficult, assisted methods like IVF give many women the chance to have a child. Your healthcare team will work with you to find the best path forward.

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