Couples need a referral for infertility testing at gynecology units. Testing is recommended after a year of trying to conceive. If you or your partner suffer from a condition that will complicate conception, it is advisable to start infertility testing and treatment sooner. The first basic infertility tests are performed at your health centre or in another outpatient facility. After these, you will be referred to a specialist, if necessary.
You will have your first appointment together, during which you will be asked questions about your health in general to assess your testing needs and to plan the appropriate tests: a semen sample, a menstrual cycle assessment, and a test to check that the fallopian tubes are open. The test set for women is conducted in different menstrual cycles.
Once the basic tests have been completed and the results are available, the couple will see a specialist together. The doctor will tell them their test results and suggest individual treatment depending on the causes of the infertility. The cause may be a condition affecting the man, the woman, or both. Sometimes the cause of infertility is not identified.
Infertility treatment options depend on the causes of infertility and the couple’s wishes. For some couples, adoption or no treatment may be the best option. It is important to eliminate factors that have a negative effect on fertility, such as weight issues and smoking.
Infertility treatment includes:
- Ovarian follicle growth stimulation (e.g. clomiphene and gonadotropin injections) to induce or stimulate ovulation
- Surgery when the cause of infertility is endometriosis, myoma or a damaged fallopian tube
- Insemination, which involves injecting selected best quality sperm into the woman’s womb at the most fertile time
- In-vitro fertilisation (IVF), which involves fertilising the egg in a laboratory dish and placing the embryo in the woman's womb
- Intra-cytoplasmic sperm injection (ICSI); a method used if the sperm count or motility is very low. ICSI involves injecting a single sperm directly into an egg with a thin glass needle.
In public health care, fertility treatment is offered to women aged 40 and younger. As a rule, treatment options do not include donated sperm or eggs, post-sterilisation treatment, or treatment to couples who have already had two biological children together. Only a limited range of treatment can be offered to persons with a high-risk infectious disease. According to the Act on Assisted Fertility Treatment, fertility treatment may not be provided if the couple requires a surrogate or if it is apparent that the child’s balanced development cannot be guaranteed.
Basic infertility tests are carried out at the Women’s Hospital and at Hyvinkää, Lohja and Porvoo Hospitals. The Women’s Hospital is the central provider of in-vitro fertilisation and ovulation induction treatment as well as the planning and provision of more complex infertility treatment.
HUS aims to initiate fertility treatments with donated gametes at the end of 2019. HUS does not accept referrals for treatments with donated cells for the time being.