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The fertility work-up

You've been trying for a year, maybe two. Still no baby. What next?

By
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Originally published in Today's Parent May 2006

Many of us assume starting a family will be as easy as pitching the pills or ditching the diaphragm, but for an estimated eight percent of Canadian couples, the pathway to pregnancy is a bit more challenging. After a year of unprotected intercourse, that’s how many people find their dream of having a baby is still just that.

Nancy and Randy Johnston’s hopes for a houseful of kids seemed to be out of reach, when, after their eldest child was born, they found themselves unable to conceive a second time. Finally, the London, Ont., couple decided to try and find out what was standing in the way of adding to their family.

So if you’re still waiting for the stork to arrive, what’s the next step?

Joint Venture
Typically, the first stop is your family doctor’s office. She should be able to conduct the initial workup and direct you to more specialized help if required. Experts emphasize that ideally, a couple should be investigated together. Why? “Male factor infertility will be implicated as the sole cause, or a contributing cause, in half the cases,” explains Ellen Greenblatt, clinical director of the fertility and IVF Clinic at Mount Sinai Hospital in Toronto. (That’s when a reason can be found at all — up to 30 percent of couples who experience difficulty conceiving are diagnosed with “unexplained” infertility.)

David Mortimer, president of Oozoa Biomedical Inc. and an expert on diagnostic andrology testing (sperm testing, to you and me), makes the case this way. “If he’s got a bit of a problem, and she’s got a bit of problem, then between them, they’ve got a bigger problem.” If both partners aren’t adequately investigated, he adds, “people may be pushed into treatment that might not be appropriate, or receive treatment that is foredoomed to failure.”

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