Infertility consultation – what tests?

Dear Professor Winston,

My husband and I have been trying to conceive for approx 2 years. Over the past 6-8 months, we have completed the initial checks with our GP, such as blood and specimen tests and all results seem to have returned fine for us both. I am 36 and my husband is 39 so we are concerned that time is against us. We have now been referred to Stoke Mandeville Fertility Clinic and our first appointment is in two weeks time. I would like to find out what we can expect from this initial referral and also what should happen? I attended the Fertility Show in London a couple of weeks ago and attended your very informative seminar. I understand from this that clinics do not always carry out the correct checks and hence I wanted to find out what we can do to make the best of our referral. Thank you very much in advance for your help. Kind regards, A

Dear A,

I am not too sure I can answer this sensibly because different clinics often do tests in a different order and also may be funded differently by your commissioning NHS purchaser. But after a proper chat and a physical examination of both of you, I would expect a cervical smear test, to arrange FSH, LH blood tests at the beginning of your cycle and a blood progesterone on day 21. In addition, two sperm counts spaced at least a month apart, an X-ray of the uterus (HSG). There after the tests will depend on what the doctor has found on examination and after taking a thorough history from you.

Best wishes
Robert Winston