Fertility Calculator

The Fertility Calculator serves as a guide to help determine if and when you should start considering medical advice, fertility tests and possibly treatments.

If you’re trying to fall pregnant, getting the timing right can significantly improve your changes. For this step, you can simply consult your doctor to determine your ovulation cycle. However, after a year of trying and struggling to fall pregnant it might be time to get in touch with a specialist. A natural journey to parenthood is not always possible but there are various alternative routes to consider.

TTC for 3 – 12 months

Trying To Conceive for 3 – 12 months

Conception does not usually happen as easily and quickly as we would expect. Becoming pregnant can take up to a year and it usually takes anything from one to nine months after contraception has been stopped.

The use of lubricants or apparatus should be avoided when trying to fall pregnant. All of the lubrication products on the market will affect sperm and their function. Even tap water can destroy them. The use of erectile enhancing drugs will not affect sperm, but should be used on medical advice.

If the woman has regular cycles and intercourse is regular too, then it may only be a matter of time or timing. In case of time, you should not be concerned and continue as usual for another six months. If you think that timing may play a role, for example one of you makes regular business trips and you are concerned that you might miss the ovulation time, then a fertility specialist may help you find out when ovulation time is. This may help the couple to plan intercourse if they want to, or just to know whether the timing in a cycle was right or not.

Seek fertility advice immediately if any of these factors are present:

  • Spinal injury
  • Menopausal symptoms
  • Post-pubertal mumps in a man
  • There is no ejaculate or semen
  • Sexual intercourse is difficult or a problem
  • Pregnancy has occurred but did not continue
  • Use of any prescription medication, chronic or acute
  • Use of any occasional injections, e.g. testosterone
    for libido or Reacutane for skin problems
  • Menstrual cycles are either
    – Absent,
    – Irregular or
    – Very Painful

TTC for > 12 months

Trying To Conceive for More than 12 Months

After a year of regular intercourse and menstrual cycles, it is a good idea to start with specific fertility assessment to establish if there are other possible reasons for not conceiving.

In cases where there is no obvious or specific test result that indicates a reason for the infertility, a basic timing of intercourse with ovulation induction or artificial insemination may be suggested as a good start-off treatment plan.

In some cases, if a specific problem(s) does come to light, a more advanced treatment plan such as ICSI should be followed. These cases include:

  • Blocked tubes
  • Abnormal hormonal profile
  • Abnormal sperm parameters
  • Tumours interfering with certain important hormones
  • Infection by a virus or bacterium that influences
    conception or may be dangerous for a baby

Female age > 37 years

Female Older than 37 Years

If the woman is older than 37 years, then IVF treatment is indicated as soon as possible. Since the oocytes’ quality declines more rapidly from 38 years of age, time is of the essence to have a good chance of pregnancy.

From 40 years of age a woman’s chances of falling pregnant and having a healthy baby decline very rapidly. Some studies have shown that an average of 80% of all eggs collected in patients older than 41 are abnormal, even if they ovulate.

If you have tried for three months at home with regular menstrual cycles and regular intercourse, but no success, it is imperative to consult a fertility specialist. A sperm test will be part of the fertility assessment and should be done at an IVF laboratory to ensure speedy and accurate results.

Initially, it is important that the man and the woman are investigated as a couple to cover the first basic tests:

  • Sperm test
  • Fertility gynaecological consultation
    – Pap smear
    – Full pelvic sonar
    – Hormonal blood tests

Both partners should be at the first consultation with the fertility specialist to ensure a good comprehensive background discussion and an explanation of IVF treatment.

Previous AI/IVF Treatment

Previous Artificial Insemination/In Vitro Fertilization Treatment

If artificial insemination has been done two to three times and failed, IVF becomes the next step in fertility treatment. Since the fertilisation and embryo quality cannot be seen, the reason for failed results is difficult to explain.

If IVF or ICSI cycles have failed before, a second opinion or an advanced technology may make a difference in the chances of a pregnancy.

Some advanced technology or strategies that we offer are:

  • The EmbryoScope™: to diagnose and evaluate abnormal cleavage patterns.
  • IMSI: to select more normal sperm than with ICSI.
  • AH: to help an embryo escape to complete the implantation process.
  • Case Discussions: Second and third opinions are readily available in one
    clinic – we have three fertility specialists who discuss individual cases in
    detail to give their expert opinion on a treatment option.
  • Endometrial Biopsy: to enhance endometrial receptivity before an IVF cycle.
  • Skilled Endoscopic Surgery

Single < 38 years

Single, Less than 38 Years Old

Not all women conceive in their optimal productive years. The reasons are many and diverse. Some of the most common reasons for postponing childbearing are to focus on career or studies. Also, some women have just not met their ‘Mr Right’ and are still waiting. With the inception of social egg freezing, it is now possible to save your fertile, potent young eggs for use later, whenever you are ready.

The main role player here is age. Oocytes lose their quality as time goes by and the most fertile years for women are between 20 and 36 years. If a woman is still single or wants to have children only later, it is a good idea to preserve her fertility and store her eggs. In this way, the biological clock is not such a factor and it also prevents the need to use donor eggs.

 

Known Diagnosis / Medical Event / Life Event

There are specific medical diagnoses that relate to fertility problems. Some have been mentioned under TTC < 12 Months, but some are very specific and an immediate indication for infertility treatment at some level. Some have a serious impact on the person’s reproductive future, and fertility preservation should be considered.

 

  • Spinal injury
  • Endometriosis
  • Chronic medication(s)
  • Hysterectomy or ovarectomy
  • Post-pubertal mumps in a man
  • Pregnancy losses or terminations
  • PCOS (Polycystic Ovary Syndrome)
  • Injury to the pelvis and/or genital area
  • Tumours, borderline tumours or cancer
  • Vasectomy or a failed vasectomy reversal
  • Abnormal ovarian/testicular development
  • Psychological disorder/mood and anxiety disorders (depression and anxiety)
  • Sterilisation by clipping or cutting of the tubes
  • Previous termination of a genetically abnormal pregnancy
  • Obesity or BMI > 30 (weight divided by height, divided by height again)
  • Genetic abnormalities or family history of genetic disease or birth defects
  • Any life events that affect your relationship i.e. rape, molestation, trauma, loss

 

Some factors do not necessarily affect fertility directly, but may cause some concerns for people in terms of the effect they may have on the child or whether they could pass it on to their children. If a genetic disorder is known in the family or it has surfaced in a previous pregnancy, genetic diagnosis of the embryos can be done at fertility institutions, and so normal embryos can be chosen for the pregnancy. This is called PGD and is done in conjunction with genetic screening laboratories that also provide the necessary genetic counselling.