Fertility Screening Referrals

Symptoms that may suggest fertility problems include:

 For women: 

• Irregular, absent, or very painful periods
• History of miscarriage
• Known or suspected PCOS
• Unexplained weight loss, hair loss, or acne, suggesting a hormonal imbalance
• Age 35 or over and trying to conceive for 6 or more months.

Seek urgent medical care by calling 000 or visiting your nearest Emergency Department (ED) if you have severe pelvic pain, heavy bleeding, fainting, shoulder-tip pain, suspected ectopic pregnancy, fever with pelvic pain, or symptoms that feel serious or rapidly worsening.

Earlier assessment may be appropriate if you are 40 or older, have irregular or absent periods, known or suspected PCOS, endometriosis, previous pelvic surgery, previous chemotherapy or radiotherapy, recurrent miscarriage, or another known factor that may affect fertility.

For men: 

• Low sex drive
• Erectile dysfunction
• Known hormonal conditions
• Reduced facial or body hair
• Problems with ejaculation
• Previous STIs or groin surgeries

In women: 

• Polycystic ovary syndrome (PCOS)
• Premature ovarian insufficiency (POI)
• Diminished ovarian reserve
• Undetected STIs
• Thyroid disorders
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In men:

• Low testosterone
• Azoospermia (absence of sperm)
• Poor sperm motility
• Genetic conditions like Klinefelter Syndrome
• Undetected STIs affecting sperm quality
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In both partners: 

• Chromosomal abnormalities that may be linked to recurrent miscarriages
• Unexplained infertility, with no clear cause identified despite standard test results being normal.

Results may show: 

• Whether eggs are being released normally during the menstrual cycle
• Hormone levels that support fertility and reproductive health
• Sperm concentration, their movement quality, and structure
• Signs of underlying inflammation or infection
• Ovarian function and remaining egg quality
• Possible reproductive health concerns that may impact the ability to conceive

Pathology-based fertility screening is often an important first step in fertility assessment, but it also has some limitations.

• Some fertility problems may not appear in routine fertility tests
• Blood tests cannot detect many structural reproductive issues or assessment by a medical practitioner, such as some tubal, uterine, ovarian, testicular or endometriosis-related problems. Imaging or specialist assessment may be needed.
• Complex or abnormal results may require referral to a fertility specialist
• Normal results do not guarantee successful conception
• Results can change over time and can be influenced by stress, hormonal changes, or illness.

Preparation actually depends on the tests prescribed. 

For blood tests (both partners):

• Fasting may be required for some tests; your doctor will advise.
• Stay well hydrated before your appointment. 
• Keep a list of all current medications and supplements ready.
• Avoid alcohol and smoking for at least 24 hours before testing.
•  

For women: 

• Some blood tests may be required at certain times during the menstrual cycle.
• Progesterone is tested around day 21 to confirm ovulation. Note: Progesterone is usually checked about 7 days before the expected period. In a typical 28-day cycle this is around day 21, but timing needs to be adjusted for longer, shorter or irregular cycles.
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For men:

• Avoid hot baths, saunas or heat exposure as heat affects sperm quality.
• Avoid ejaculation before semen analysis. Note: For semen analysis, the collection centre will usually advise an abstinence period, commonly 2 to 7 days. Too short or too long an interval can affect the result.