1. Understanding Infertility
Failure to achieve pregnancy after 12 months of regular, unprotected intercourse (6 months if the woman is ≥ 35 years old).
Affects - 1 in 6 couples worldwide.
Common Causes:
– Female: Ovulatory disorders, tubal factors, endometriosis, diminished ovarian reserve
– Male: Low sperm count, motility/morphology issues, erectile dysfunction
– Combined or unexplained factors
2. The Role of the GP
GPs are often the first point of contact people facing infertility and play a key role in building trust, providing reassurance, and initiating evaluation.
Initial evaluation includes history, physical examination, and lifestyle assessment.
- Semen analysis
- Mid-luteal progesterone (ovulation check)
- Basic hormonal profile (FSH, LH, TSH, prolactin)
- Pelvic ultrasound if indicated
- Female age >35 with >6 months trying
- Abnormal semen parameters
- History of pelvic surgery, PID, or endometriosis
- Amenorrhea or irregular cycles
3. Supporting Patients Emotionally
Infertility can bring grief, frustration, and stigma. GPs should provide emotional support by acknowledging feelings, choosing sensitive language, normalising the experience, and referring to support groups or counselling when needed.
4. Lifestyle & Preconception Counselling
Encourage patients to optimise their preconception health:
- Maintain a healthy BMI
- Stop smoking and limit alcohol
- Engage in regular exercise
- Take folic acid supplementation
- Reduce caffeine and stress
- Encourage timed intercourse
5. Referral Pathways
When indicated, refer to:
1. Our expert specialists at Life Fertility Clinic Sydney:
- Professor Michael Chapman
- Dr Louise Fay
- Dr Shannon Zawada
- Associate Professor Rebecca Deans
- Dr Karen Kong
2. Psychological support services when distress is high.
6. Key Takeaways for GPs
- Be proactive in early identification
- Initiate first-line investigations
- Support patients holistically
- Provide empathetic communication
- Refer appropriately and timely
With informed guidance and compassion, GPs can help patients take the next step in their journey to parenthood.
PRE-TREATMENT SCREENING TESTS
FEMALE
- Karoyotype
- LH/FSH
- FBE/FBC
- AMH
- Iron Studies
- Blood Group & Antibodies
- Rubella
- Varicella
- Hep B
- Hep C
- TFT
- Thyroid Antibodies
- Syphilis
- Vitamin D
- HIV
- Pelvic Ultrasound
MALE
- Karoyotype
- LH/FSH / Testosterone
- FBE/FBC
- Hep B
- Hep C
- Syphilis
- HIV
- Semen Analysis and Sperm Antibodies Testing