Female infertility is a common problem and GPs should be able to elucidate potential causes by efficient history taking and performing initial investigations as appropriate.
- Preconceptual advice for females includes lifestyle advice, such as maintaining a normal body mass index, and a discussion on the detrimental effect of female age on fertility.
- A preconception blood screen should be performed in all women who want to conceive. This includes a full blood count, blood group, thyroid function tests, rubella, varicella, hepatitis B and C, and HIV serology.
- The next steps in management involve hormone assessment as well as a transvaginal ultrasound and assessment of the fallopian tubes using a hysterosalpingogram (HSG) or hysterosalpingocontrast-sonography (HyCosy).
- Couples should be tested and referred after 12 months of trying to conceive if the female is younger than 35 years of age, and after six months if the female is older than 35 years.