Infertility: Specific Conditions

This outlines management of specific fertility problems. Of course each situation is unique and recommended options will depend on the individual.

Irregular ovulation / no ovulation

  • Modification of diet and exercise
  • Correction of any general health problems
  • Clomiphene or Letrozole pills with ovulation tracking
  • FSH injections with or without intrauterine insemination
  • IVF

Low egg quality / reserve

  • Ensuring there are no contributing factors
  • IVF using your own eggs +/- adjuvant therapy such as DHEA
  • Donor egg IVF
    • Recruiting an egg donor
    • Importing frozen eggs from the European Egg bank
    • Using a commercial donor egg IVF unit in another country

Unexplained / multifactorial infertility

  • Correction of any general health problems
  • Intrauterine insemination with ovulation tracking and sometimes ovulation induction
  • IVF
  • Tubal flushing (HSG with lipiodol)


  • Laparoscopic excision
  • IVF +/- prior medication

Uterine Abnormalities

Polyps are easy to fix with hysteroscopy at the Mater or Genea Day Surgery Unit. We often achieve success without operating on fibroids and other, larger uterine pathology (for example intrauterine adhesions). Surgery, if needed, is done at either institution depending on its nature.

Low sperm counts / reduced quality

  • Correction of any general health problems
  • Specific medications
  • Intrauterine Insemination
  • IVF: sometimes using intracytoplasmic sperm injection (ICSI)

Recurrent Miscarriage

  • Standard investigations and treatment of specific causes if found
  • IVF using PGD to select “healthy” embryos

Previous permanent sterilisation procedures

  • Microsurgical reversal
  • IVF: sometimes in conjunction with collecting sperm directly from the testes (if the vasectomy is not reversed effectively)

Damaged / Blocked tubes

  • IVF
  • Surgical correction (usually microsurgery/minimally invasive surgery)

Complete absence of sperm in ejaculate (Azoospermia)

Luckily, sperm can often be found and retrieved from the testes by needle aspiration or biopsy. I have delivered babies created from testicular aspirates containing just several sperm.