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  • Q&A with Australian Health Practitioners

    What should I do next to improve my chance of conceiving?

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    Infertility Trying To Conceive
    Hi I have irregular periods and have been seeing a GP from couple of months. I don't have Ovulation. I was on clomid with a low response. Ovulation happened just once. She referred me to a gynaecologist. What should be my next step. Please help. My age is 29years
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  • Dr Joseph Jabbour

    Gynaecologist, Gynaecologist - Infertility (IVF) Specialist, Obstetrician

    Dr Joseph Jabbour is a specialist Obstetrician & Gynaecologist and Fertility Specialist with Monash IVF situated in Sunnybank (Brisbane Southside). Dr Jabbour has had the … View Profile

    I believe a referral to the gynaecologist is a good step.

    Although you may not be ovulating, infertility can be male factor infertility and you should present with your partner. A thorough history and examination of the couple is done to try and narrow down the potential cause or causes for your difficulties with conceiving. 

    Prior to ovulation induction, it is important to check that your fallopian tubes are patent. This would require an ultrasound scan infused with saline or an xray with dye infused into the uterine cavity to check the patency of the tubes. A Semen Analysis is also required to rule out male factor infertility. Checking your ovarian reserve is a good idea and a blood test can achieve this. The test is called Anti Mullerian Hormone test. Checking your hormone levels and your thyroid function test is warranted. If you suffer from severe period pain, pain with intercourse or chronic pelvic pain, a laparoscopy would be recommended to diagnose and treat endometriosis. Endometriosis is associated with a risk of up to 15% infertility and managing it will improve the fertility rate. 

    In terms of ovulation induction, clomiphene can be used but this would require monitoring with serial ultrasound scans. The success rate of it diminishes once you attempt it for 2-3 cycles with no effect. Letrozole is another medication that may be more useful than clomiphene with a better effect on the endometrial cavity. It may achieve better success rates. 

    If these management plans fail, a referral to a fertility specialist is warranted for a discussion of the option of Ovulation Induction with Intrauterine Insemination or IVF. 

    I have attached a link to an article on my website which I hope will outline your options.

    All the best.

    http://sunnybankwomens.com.au/Blog/Infertility

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