Potential consequences of delayed referral to Fertility  Specialist

Potential consequences of delayed referral to Fertility Specialist

  • reduced natural conception rates,
  • reduced success for intrauterine insemination (IUI) and ART
  • increased risk of miscarriage following ART

Reduced natural conception rates

  1. Age-related decrease in natural maternal fertility is due to a decline in egg number and quality and increasing ovarian ging.
  2. The decrease in natural paternal fertility due to age is less defined, but may be due to endocrine abnormalities, genetic abnormalities, or poor sperm quality.
  3. Early evaluation and referral to a specialist can limit the effect that age has on a couple’s fertility.

  Reduced IUI success rates

  • The success rate for IUI also declines with female age
  • A study that included 1,117 IUI cycles reported that the live birth rate age group wise

Age Group

Live Births

< 25 years

26.7 %

25 – 29


30 – 35


36 – 39


> 40



Increased risk of miscarriage following ART

The gradual reduction in the live birth rate as women age was reportedly due to an increase in the number of miscarriages because of genetic abnormalities in the egg.

When to suspect the problem?

  • If the woman is under 35 and has tried unsuccessfully to conceive for more than 12 months
  • Or if the women is over 35 and has tried for more than 6 months
  • If the couple meets either of these criteria then couple may need to be evaluated.
  • Male partner having problem of low sperm count or motility.
  • Associated factors like blocked or unhealthy tubes, endometriosis, and poor ovarian reserve.
  • Although couples frequently turn to their Ob/Gy for initial fertility guidance referral to an infertility specialist may be necessary.
  • Referral should be to tertiary Level
    Defined as a practitioner with certification or documented experience in ART, reproductive endocrinology, or urology/ andrology who offers infertility counselling services and is able to manage complicated female and male infertility and provide direct access to male and female microsurgical services, ART, and other related services.