Fertility problems are a common concern for many women across the world. Globally, there were 110.1 million cases of female infertility in 2021, according to Global Burden of Disease data, with both the number of women affected and the overall health impact having increased significantly since 1990.
However, while female infertility has increased in prevalence, and is expected to continue rising over the coming decades, it’s important to know that this does not necessarily mean your fertility will be affected. Additionally, experiencing fertility difficulties does not mean that you will never have children. In many cases, women may not need to undergo In-Vitro Fertilisation (IVF) or other complex fertility treatments.
Expert gynaecologists, such as those at The Gynae Centre, are able to treat a wide range of gynaecological and hormonal conditions that can affect fertility. By identifying issues early and offering appropriate treatment, it is often possible to support natural conception. that support natural conception where possible. With specialist expertise and access to modern diagnostic technology, even complex cases can be assessed and managed, with many patients going on to achieve healthy pregnancies.
Dr Patricija Kasilovska, Consultant Gynaecologist at The Gynae Centre, explains, “Many causes of infertility can be diagnosed and treated by your gynaecologist. In fact, for women with known or suspected conditions such as Polycystic Ovary Syndrome (PCOS), fibroids, endometriosis, pelvic infections, a history of sexually transmitted infections, or previous pelvic surgery, a gynaecologist should be the first point of contact. If investigations show that specialist fertility treatment is required, referral to a fertility specialist can then be made to ensure the most appropriate care.”
Why might you see a gynaecologist instead of a fertility consultant?
When fertility concerns arise, many women assume that a fertility clinic should be their first step. In reality, seeing a gynaecologist first is often the most practical and effective approach, particularly if you have symptoms or a known gynaecological condition.
One important reason is speed. Within national healthcare pathways, women are often referred from their GP to a gynaecologist before being considered for fertility services, which can involve waiting lists of several months or longer. As age plays a crucial role in fertility outcomes, such delays can feel significant. By seeing a gynaecologist directly, investigations can begin sooner.
General guidance suggests seeking medical advice after 12 months of trying to conceive for women under the age of 35, or after six months for women aged 35 and over. However, this is not a rule that must be followed. If you have existing health concerns, worrying symptoms, or would simply like reassurance, there is no need to wait. Early assessment can reduce anxiety and, in many cases, identify issues that are straightforward to treat.
You may consider booking an appointment with a gynaecologist if you have been trying to conceive without success and also experience:
- Abnormal uterine bleeding
- Irregular periods (very heavy, absent or particularly painful)
- Ongoing pelvic pain
- A history of ectopic pregnancy
- A diagnosed or suspected gynaecological condition, such as PCOS or endometriosis
- A desire for peace of mind before continuing to try to conceive
A gynaecologist can carry out detailed assessments, including imaging such as a transvaginal ultrasound or hysteroscopy, as well as blood tests. This allows them to determine whether treatment is possible without fertility interventions or whether referral to a fertility specialist is appropriate. Where referral is required, having investigations already completed helps ensure a smoother and more efficient pathway to specialist care.
Causes of fertility problems in women
Female fertility can be affected by a wide range of factors, many of which are medical conditions that gynaecologists diagnose and manage routinely.
- Ovulation problems: Disorders of ovulation are estimated to account for approximately 25% of infertility cases in the UK. Conditions such as PCOS, thyroid disease or hormonal imbalances can interfere with regular ovulation. Identifying and treating these issues can often restore ovulation and improve the chances of conception.
- Tubal damage or blockage: The fallopian tubes play a vital role in conception by allowing the egg and sperm to meet. Previous pelvic infections, untreated sexually transmitted infections, or prior surgery can lead to scarring or blockage. Imaging investigations arranged by a gynaecologist can assess tubal health and guide further management.
- Uterine abnormalities: Fibroids, polyps, structural abnormalities or scarring can affect implantation or increase the risk of miscarriage. Many of these conditions can be managed medically or surgically by a gynaecologist, sometimes removing the need for fertility treatment altogether.
- Endometriosis: Endometriosis can affect fertility through inflammation, adhesions, and scarring. Diagnosis is often based on symptoms and imaging, with laparoscopy used where indicated. Early recognition and tailored management can improve symptoms and fertility outcomes, particularly when treatment is started promptly.
- Premature ovarian failure: Also known as premature ovarian insufficiency (POI), this occurs when the ovaries stop functioning normally before the age of 40. While it can have a significant impact on fertility, early diagnosis allows women to explore appropriate options with clear medical guidance and support.
What to do if you have trouble conceiving
While fertility problems can feel overwhelming, in many cases the underlying causes can be identified and treated by an experienced gynaecologist.
Seeing a consultant gynaecologist early offers timely assessment, clear answers, and a personalised plan based on your health and circumstances. Where specialist fertility treatment is needed, your gynaecologist can ensure you are referred appropriately, with all relevant investigations already in place. Most importantly, it provides reassurance that you are taking informed steps towards understanding and supporting your fertility.
To book a consultation with a consultant gynaecologist for fertility issues at The Gynae Centre, please use our easy-to-use online booking system, or call 020 7580 8090 to speak to one of our friendly team members.
