The first step in considering treatment is the fertility assessment. The assessment includes your history, review of test results and discussion on fertility plans.

For the female partner, important fertility factors assessed include the ovarian reserve, (indicated by AMH or an antral follicle count), the uterine environment, and fallopian tubes.

For the male partner, an assessment of general healthy, semenanalysis and environmental factors that influence the sperm quality.

These are reviewed in conjunction, with consideration of duration of trying, age, and desired family size to tailor the correct treatment. I also use this opportunity to discuss sexual frequency and any difficulties in achieving regular intercourse as this a relatively common cause of infertility.