Associate Professor Tsaltas Explains Infertility

What is infertility – and when to see help?

Affecting 10-14% of the population, infertility is defined as the inability to conceive:


• after 12 months of trying if the female partner is under 35 with regular cycles, or
• after 6 months of trying if the female partner is 35 years or over.


I recommend that couples seek help earlier if the female partner has irregular cycles.

What are the causes of infertility?

You may be struggling to conceive for several reasons – and causes may be female or male in origin. However, in one third of cases, there is no explanation at all.

What basic investigations should be performed as a first step?

If you believe you may be infertile, some initial tests could help determine the cause. Most of these tests can be performed by your GP before you come to see me.


I generally recommend a simple semen test for the male partner. However, the female may need to undergo a variety of tests, including:
• Hormone profile
• Vaginal ultrasound
• Ovulation – D21 Progesterone
• Rubella and chicken pox immunity, FBE & Film (Thalassaemia Screen if appropriate)
• Ovarian Reserve – AMH (anti-mullerian hormone)

What fertility treatments are available other than IVF?

Importantly, IVF is not the only fertility treatment and many of my patients succeed with other approaches. Once we have a clearer understanding of your situation, I will talk to you in detail about ongoing management and treatment strategies.


Some other treatment options include:

  • Clomiphene citrate: Available in tablet form, clomiphene citrate is a fertility drug used in women who do not ovulate. It is designed to stimulate ovulation.
  • Gonadotrophins ovulation induction: Available in injection form, this treatment is designed to stimulate the production of eggs. Once eggs are developed, the patient receives another injection (HCG) to trigger ovulation. Intercourse is then timed accordingly.
  • Intrauterine insemination: Often combined with ovulation induction, this treatment involves collecting and preparing sperm in the IVF lab before transferring it into the uterus.
  • Surgery: Some women may need surgery (laparoscopy or hysteroscopy) to treat conditions that are preventing conception – such as endometriosis, fibroids or polyps.