Care Plus Infertility Department, has OPD Clinic opened since inception of Care Plus Hospital. Our medical facility specializs in diagnosing and treating infertility. we offer wide range of services, including diagnostic testing, various treatment options, and emotional support for patients facing fertility challenges. 

Infertility Overview
What is Infertility?
● Defined as the inability to conceive after one year of regular unprotected sex.
● about 1 in 7 couples.
● Over 80% of couples (woman under 40) conceive naturally within a year if they have sex every 2–3 days.
● After 3 years of trying, the chance of conceiving in the following year drops to 1 in 4 or less.
When to Seek Help
● See a Doctor after 1 year of trying without success.
● Women aged 36+ or with known fertility issues should see a Doctor sooner.
● A diagnosis is made after a couple fails to conceive for a year.
Types of Infertility
● Primary infertility: No previous pregnancies.
● Secondary infertility: Difficulty conceiving after one or more past pregnancies.
Causes of Infertility
● Ovulation issues
● Poor quality semen
● Blocked/damaged fallopian tubes
● Endometriosis
● In 25% of cases, no cause is identified.
Addressing Risk Factors
● Age – fertility declines with age
● Weight – obesity or being underweight can affect ovulation and sperm quality
● STIs – such as chlamydia
● Smoking – reduces fertility and semen quality
● Alcohol – affects sperm; safest to avoid during conception attempts
● Environmental exposures – pesticides, metals, solvents
● Stress – impacts sex drive, ovulation, and sperm production
Treatment Options
● Medical treatments – for ovulation issues
● Surgical treatments – to address endometriosis, blocked tubes, or scarring
● Assisted conception – including IUI and IVF
● Treatments vary by cause and are subject to local ICB availability.
● Private treatment is an option but can be costly and isn’t guaranteed to work.
Potential Complications of Treatment
● Multiple pregnancy – common with IVF, increasing health risks
● Ectopic pregnancy – risk is slightly elevated with IVF
Causes of Infertility (Brief Overview)
General
● 1 in 4 couples experience unexplained infertility.
Female Infertility
● Ovulation issues: PCOS, thyroid disorders, premature ovarian failure.
● Surgery: Scarring from pelvic or cervical procedures.
● Cervical mucus issues: Can hinder sperm movement.
● Fibroids: May block implantation or fallopian tubes.
● Endometriosis: Tissue growth outside the womb can damage reproductive organs.
● PID: Infection can scar fallopian tubes.
● Sterilisation: Usually irreversible.
● Medications/Drugs: NSAIDs, chemotherapy, antipsychotics, spironolactone, illegal drugs.
Male Infertility
● Semen quality: Low count, poor movement, abnormal shape.
● Testicle issues: Infections, cancer, congenital defects, injury, undescended testicles.
● Sterilisation (vasectomy): Often not reversible.
● Ejaculation disorders
● Hypogonadism: Low testosterone, possibly from drugs or genetic disorders.
● Medications/Drugs: Sulfasalazine, anabolic steroids, chemotherapy, herbal remedies, illegal drugs.
Unexplained Infertility
● No identifiable cause in ~25% of cases.
● IVF recommended after 2 years of trying without success.
Diagnosis and When to Seek Help
● Conception Stats: Over 80% of couples where the woman is under 40 conceive naturally within a year of regular unprotected sex (every 2–3 days).
See a Doctor if:
○ You haven’t conceived after 1 year of trying.
○ You’re female and aged 36 or older.
○ You have fertility concerns (e.g. past STI, cancer treatment).
Initial Doctor Assessment
● Both partners should attend.
● Doctor will ask about:
○ Medical and sexual history
○ Previous pregnancies/children
○ Duration of trying to conceive
○ Frequency and any issues with sex
○ Time since stopping contraception
○ Lifestyle (smoking, alcohol, drugs, stress, weight)
Physical Exam
● Women: BMI check, pelvic exam (check for fibroids, endometriosis, PID)
● Men: Exam of testicles and penis for lumps or abnormalities
Fertility Tests
● Women:
○ Blood tests: Check for ovulation (progesterone, gonadotrophins)
○ Chlamydia test: Swab or urine
○ Ultrasound scan: Check ovaries, womb, fallopian tubes
○ Hysterosalpingography (X-ray): Detect blocked tubes
○ Laparoscopy: Camera inserted into abdomen for deeper investigation
● Men:
○ Semen analysis: Assess sperm count and movement
○ Chlamydia test: Urine sample
Next Steps
● Based on findings, you may be referred to a specialist or fertility clinic.
Fertility Treatment Overview
Types of Treatment:

1. Medicines
   ○ Clomifene / Tamoxifen: Stimulate ovulation.
   ○ Metformin: Useful for PCOS.
   ○ Gonadotrophins: Help ovulation in women & improve fertility in men.
   ○ Note: Ovulation-stimulating drugs not recommended for unexplained infertility.
   ○ Side effects: Nausea, hot flushes, headaches, etc.
2. Surgical Procedures
   ○ Fallopian Tube Surgery: Clears blockages/scarring.
   ○ Endometriosis/Fibroids/PCOS: Treated via laparoscopy or ovarian drilling.
   ○ Male Infertility: Surgery to fix epididymal blockage or extract sperm.
3. Assisted Conception
   ○ IUI: Sperm inserted into the womb.
   ○ IVF: Eggs fertilised outside the body and implanted.
   ○ Egg/Sperm Donation: IVF using donated reproductive cells; donor identity disclosed to child at age 18. or over NDA Terms.