When should fertility treatment start? When to go to the hospital and how to treat

In recent years, we often hear the word fertility treatment. Some of you may feel that you are also infertile. However, you may not know what kind of condition is infertility and when you should go to the hospital.

In this article, we will explain the definition of infertility, causes, and when to go to the hospital. In addition, we will explain in an easy-to-understand manner what is actually examined at the hospital and the specific treatment method, so please refer to it.

Find out in this article

  • definition of infertility
  • causes of infertility
  • When to start treatment or consultation
  • Infertility test content
  • infertility treatment

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What is infertility

Infertility is defined as the inability to conceive after a year or more of unprotected sexual intercourse between healthy men and women. In the past, infertility was defined as a period of one to three years without conception, and was commonly defined as two years. However, in 2015, the Japan Society of Obstetrics and Gynecology defined infertility as being unable to conceive for more than one year.

In addition, according to the Japanese Society of Reproductive Medicine, the frequency of infertility increases in women over the age of 30, and the possibility of natural conception decreases. Therefore, older women are recommended to see a doctor even if they have not been pregnant for less than a year.

causes of infertility

The cause of infertility was previously thought to be female. However, it is now understood that half of the causes are not only on the female side, but on the male side.

Here, we will explain in an easy-to-understand manner the possible causes for both women and men.

female cause

On the female side, the main causes include ovulatory disorders in which ovulation does not occur, adherence or obstruction of the fallopian tubes, and uterine diseases such as endometriosis and uterine fibroids . In addition, there are cases where the immune system is the cause, such as a constitution that creates anti-sperm antibodies that attack sperm.

male cause

On the male side, the causes are a small amount of sperm in the semen, poor motility, poor sperm condition, erectile dysfunction (ED), sexual dysfunction that prevents ejaculation during intercourse, and blockage of the vas deferens. Therefore, even if you can ejaculate, you may not be able to eject the sperm.

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When should infertility treatment start?

The general rule of thumb for starting infertility treatment is when you haven't conceived for at least a year even after having sex without contraception.

However, if there is a disease in the uterus or ovaries, or if there is a problem on the male side, this is not the case. It is a good idea to take a medical examination at the timing when you want to receive it.

Also, the older you get, the less likely you are to conceive naturally. It is known that the success rate of assisted reproductive technology such as in vitro fertilization and artificial insemination, which are methods of infertility treatment, is higher the younger the age. If you are older, it is recommended that you see a doctor as soon as you wish to become pregnant, rather than waiting for one year to pass.

Others find out that they are infertile after they have been on birth control for several years and start thinking about having children. Even if you don't think about it right away, couples who are thinking about having children in the future are recommended to have the test together when the woman turns 33 or 34.

When do you go to the hospital?

When you think you might be infertile, it's always okay to visit a hospital.

When it comes to timing to see a doctor, you may be wondering when you should see a doctor during your menstrual cycle. I will explain what to check according to the menstrual cycle.

  • During menstruation: blood test
  • Time between menstruation and ovulation: Hysteroscopy or hysterosalpingography
  • After ovulation: blood test

As mentioned above, it is possible to have an examination at any time of the day. In other words, as soon as you decide to go to the hospital, it is best to see a doctor.

What are the infertility tests?

Here are some common tests for infertility. It's reassuring to have an image of what kind of test you're going to perform before you undergo a medical examination.

The contents of the examination may differ depending on the situation, such as the hospital and age, but please refer to it.

Ultrasound examination

Ultrasonography checks for abnormalities in the uterus and ovaries. A thin instrument is inserted through the vagina, and an ultrasound image is displayed on the monitor screen to make a decision.

Ultrasound examination is an essential examination that can observe the state of the uterus and ovaries at close range.

hormone test

Hormone testing is an important test to check for abnormalities in ovulation. During the low temperature period from menstruation to ovulation, hormone secretion levels such as LH (luteinizing hormone), FSH (follicle stimulating hormone), PRL (prolactin), and E2 (estradiol) are controlled. Check the secretion of E2 and P4 (progesterone).


A salpingogram checks to see if the fallopian tubes are functioning properly. A contrast agent is injected into the uterus and X-rays are taken to observe the thickness of the fallopian tubes, the presence or absence of adhesions, and the shape of the uterus. Although the test is a little painful, many women become pregnant naturally after the test.

Hooner test

The Hooner test is a test performed after intercourse. Have intercourse on the expected day of ovulation, and check the state of the sperm in the cervical mucus the day after intercourse.

The Huner test confirms the compatibility of sperm with cervical mucus. However, even if there are no problems in both men and women, the results can be bad, so if the results are unsatisfactory, the test is often repeated the following month.

semen test

A semen analysis examines the amount of semen, sperm concentration, motility, and sperm morphology. Sperm after abstinence period of 2-7 days are subject to testing.

Semen test results can vary widely from test to test, so multiple tests may be done if the results are poor.

How to treat infertility

There are three main types of treatment for infertility. These are the timing method of intercourse according to the ovulation date, artificial insemination in which sperm is directly injected into the uterus, and assisted reproductive medicine in which the egg is removed, fertilized outside the body, and the fertilized egg is returned to the uterus. I will explain each in detail.

timing method

In the timing method, the ovulation date is predicted and intercourse is performed according to the timing. The ovulation day is predicted based on the size of the follicle, which is the bag containing the egg, measured by ultrasound from the vagina. The timing method is the basis of infertility treatment. Some people often measure their own basal body temperature to predict the ovulation date, but in reality, it is difficult to predict the exact ovulation date from the basal body temperature alone. If you want to get the timing right, we recommend that you see a gynecologist.

Artificial insemination

Artificial insemination is a method of injecting sperm into the uterus during ovulation. The mature, motile sperm are selected from the semen and injected through a thin tube at the timing of ovulation.

Artificial insemination is often indicated for infertility caused by male factors, such as problems with sperm count or motility, or erectile dysfunction (ED).

assisted reproductive medicine

There are two methods of assisted reproductive technology: in vitro fertilization and microinsemination. This method is often selected when pregnancy is difficult with the timing method or artificial insemination explained above.

Both in vitro fertilization and microinsemination are methods in which the egg is removed from the ovary, fertilized with sperm outside the body, and the fertilized egg is returned to the uterus. In in vitro fertilization, the egg is sprinkled over the sperm as it is, and in microinsemination, one sperm is injected into the egg while observing it under a microscope using a precision instrument.


Infertility is defined as the inability to conceive after one year of unprotected intercourse. If this applies to you, it is recommended that you see a gynecologist as soon as possible. Once the cause is determined through testing, treatment can be selected based on the cause.

In addition, it has been reported that the younger the age, the higher the possibility of natural conception and the higher the success rate of fertility treatment. Older people should seek medical attention early.

In this article, we have introduced several infertility tests and treatment methods. Having knowledge will help ease your anxiety until you actually see a doctor. Please use it as a reference.

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