For most couples who have concerns about infertility, the first port of call is their general practitioner, MD or family doctor. He or she will discuss the problems you have been having and may help identify obvious health or lifestyle factors that may be getting in the way of conception. Your doctor may also be able to run some basic tests within their office or surgery, or they may collect samples to send to your local hospital.
Access to infertility specialists is usually straightforward but access to free treatment as part of national health schemes varies widely from country to country across the world. If your country has a national health scheme, you may be able to have your infertility problem diagnosed by an infertility specialist, usually a gynaecologist or andrologist, as part of this service. You will be seen in a dedicated fertility clinic or centre within a state medical system.
Treatment may be free of charge; in the UK women have access to up to three cycles of infertility treatment on the National Health Service, while in Israel women have access to unlimited free IVF up to the age of 45, or the production of two healthy children. In many other countries, there is no national provision whatsoever and all infertility treatments must be paid for privately.
If state healthcare is not available, you need to see an infertility specialist working in the private healthcare sector. Depending on the regulations that apply in the country where your treatment takes place, you may need to be referred for treatment or you may be able to approach an infertility specialist directly; searching online or going by a personal recommendation are both good starting points.
In countries such as the United States, you have to access infertility specialists privately from the start, making your own appointment with an obstetrician or gynaecologist at your chosen hospital. You will need to check carefully whether your medical insurance cover provides for infertility treatment, and if so, what limits are placed on payouts. One advantage of this system is that you can stay with the same team throughout your infertility treatment, instead of having to switch from the public to the private sector as your free entitlement runs out, but it can be extremely costly.
Once you are under the care of an infertility specialist, establishing the reason for your infertility can be a simple matter but it often becomes quite complex. After several tests you may be no nearer finding out the cause of your infertility but that does not mean that infertility treatments will not work. Your infertility specialist will offer advice and treatments regardless of whether the cause of your infertility is known.