Investigations: finding out why it’s not happening

The following tests are usually standard in the investigation of causes of infertility:

  • Semen analysis including a sperm antibody check (“IBT”) for the male partner
  • Hormone investigations for the female partner
  • Anatomical testing for the female partner — this is often a pelvic ultrasound combined with an ultrasound based assessment of the Fallopian tubes (to ensure no blockages) — this test is called HyCoSy.

Other tests often undertaken early on are a pre-pregnancy screen for the female partner (if your GP has not already undertaken this) and infection screening blood tests for both partners — particularly if assisted conception is planned.

There can be wide variability in the results of these tests and sometimes Mark will want tests undertaken at a laboratory that have not been suggested by a referring GP. In particular, basic sperm testing is usually insufficient to make a diagnosis and Mark strongly prefers detailed sperm testing undertaken at a Genea Andrology lab. If in doubt, please call ahead of your consultation — many men are frustrated that they had undertaken a basic test, ordered by their GP, only to then have Mark request a further more detailed test. Calling ahead of time can save unnecessary duplication of tests that you undertake.

If your story is strongly suggestive of endometriosis or this problem is seen on ultrasound, then laparoscopic surgery may be indicated, particularly to improve your chance of natural conception. Even without any symptoms, diagnostic laparoscopy can play an important role, especially if there is the opportunity for a couple to try on their own for say a further 6 to 12 months.


Infertility is a medical problem that has a variety of causes. It is important that a diagnosis for your infertility is made so that appropriate treatment strategies are put into place. This is no different to other medical issues — for example, if a person had chest pain, they would see a doctor and with the help of history, examination and tests, a cause can be established and an appropriate treatment plan given.

Seeking alternative medicine strategies that are unproven and do not involve a proper diagnostic pathway, can disadvantage you and waste your time (and money!).


1. First steps: Your initial consultation

2. Investigations: finding out why it’s not happening

3. What to do about it: treatment