Weight and BMI
Your GP may weigh you and your partner and calculate your body mass index (BMI).
They may advise you to lose weight if your BMI is high (particularly if it is over 30).
Losing weight will improve your fertility and increase your chances of becoming pregnant.
Physical examinations
They may also do a general physical examination like checking your blood pressure and listening to your heart and lungs. Sometimes more intimate examinations are needed, depending on your situation.
For women, they may sometimes need to do a vaginal (internal) examination. This helps your GP assess your womb and ovaries.
For men, they may need to examine your penis and your testes to check for any abnormalities.
Tests for women
Blood tests
Your GP may wish to perform some blood tests. This could be to check:
- for hormonal imbalances that could affect your fertility
- your general health
- if you are ovulating
The timing of these tests depends on when your last period was.
The interpretation of fertility blood tests can be complicated at times. Some GPs may prefer to refer you to a specialist for these tests.
STI test
Your GP may offer you testing for sexually transmitted infections (STIs) such as chlamydia and gonorrhoea. These can affect your fertility.
This test involves placing a swab (that looks like a cotton bud or Q tip) into your vagina or against your cervix (the neck of the womb).
You may be asked to perform the swab on yourself or to provide a urine sample. If chlamydia or gonorrhoea are detected, they can be treated with antibiotics.
Ultrasound scan
Your GP may refer you for an ultrasound scan. This scan can check your womb, your fallopian tubes and your ovaries.
Sometimes a scan can help diagnose conditions like polycystic ovary syndrome (PCOS).
Tests for men
Semen analysis
One of the main tests for men is called a semen analysis.
A sample of the man's semen is analysed in a lab. The amount of sperm in the sample is counted and the quality is checked.
You can have sex during the 7 day period before giving the sample. But do not have sex or masturbate for 48 hours before the sample.
Your GP will usually provide you with a sterile container. Do not open the container until you are ready to produce the sample.
Wash your hands and genitals and dry thoroughly before giving the sample. Do not use a sheath or condom, as these are harmful to sperm.
Collect the specimen by masturbation. Put the entire specimen directly into the container. It is important that you collect the whole sample.
Seal the container immediately afterwards with the lid only. Do not use adhesive tape. Write your name, date of birth, clinic number, period of abstinence and date and time of production on the label. Complete the form provided.
Your GP will advise you on where to bring the sample. Normally you will need to deliver the sample yourself as it is important that it reaches the lab without delay.
Deliver the sample and completed form to the laboratory within 1 hour of giving the sample. You may be advised to keep the sample warm by carrying it under clothing near to your body.
STIs
Your GP may also test you for common sexually transmitted infections (STIs). Diseases like chlamydia can sometimes cause problems with fertility.
This is usually done by testing a sample of urine. If you have symptoms such as discharge from the tip of your penis (urethral discharge), your GP may need to take a swab from the tip of your penis.
What happens after the tests
The next steps depend on the results of the physical examination, blood tests and semen analysis.
It is common for a GP to refer you to a fertility specialist or a urologist (a doctor who specialises in the male genitourinary tract). This is so you can have more investigations performed.