When should I see a doctor?
If you are under 35 and have no other medical problem apart from not being able to conceive, you should be having one year of well-timed and unprotected intercourse and if it does not result in fertility then you require to visit a fertility specialist.
If a person is over 35 or have known complications then one should try consultation after 6 months.
In my observation I now see that stress and late hours jobs leaves little time to wait and watch and increasingly couples in their early 30's are also seeking help with in one year of marriage.
It is seen as Primary Infertility when a woman has never been able to conceive even once.

Who is Infertile? Me or my partner?
Infertility should always be seen as couple problem and both partners should give first visit together.
One third of cases may have female factor (ovulation disorder, tubal problem, hormonal imbalances, genital or urinary tract infections), one third may have male factor (poor sperm count, poor motility of sperms, erectile dysfunctions), one third may have problem in both of the partners or the cause may be unknown, but in any of the situation the suffering person need the support of other partner to go through the complete treatment and yield result out of it.

Why am I not able to conceive the second child?
This is known as secondary infertility where although you may have conceived naturally very easily before but now it is not happening. Reasons can be multiple like infrequency of intercourse, infections of genital tract, hormones imbalances, weight gain, poor formation of eggs, development or progression of endometriosis, decline in sperm count.

Is Infertility treatment a long and tiring process?
Well, not always.
Some couples just need little guidance about lifestyle modifications and some basic investigations and they soon turn up with the positive pregnancy test. Usually the treatment starts with a basic blood investigation of both husband and wife which tells the general health and hormonal balance and husband's semen analysis, and then a tubal pat ency test with follicular tracking follows. Most of the time we can find the problem with these test and treatment is decided accordingly. There are couples where seemingly every detail turns out to be right and they fall under unexplained cause of infertility. Here the treatment is decided considering their age and duration of infertility. Also the more is the duration of infertility the more intense the treatment becomes.

What is a normal menstrual cycle means?
Menstrual rhythm has an important role to play. A normal menstrual cycle has 28-30 days . Any variation from 26 days to 35 days is fine but cycle shorter than 26days or longer than 35 days needs evaluation if there is some problem with fertility. Hormonal investigation and an ultrasound is required to find out the cause.

What is follicular tracking (Monitoring)?
ULTRASOUND is the best gift of science for treating infertility, as it unravels one of the most important aspects of human reproduction ie follicular formation. A FOLLICLE is a fluid filled structure which carries an egg seen only by a microscope but by watching a follicle grow and attain a mature shape and then its disappearance tells us that the egg has been released by rupturing of follicle .

What is HSG (Tubal patency test)?
HSG (Hysterosalpingogram) is a test where a dye is instilled into uterus and tube and and it travels through uterus and tubes it tells us about the shape of uterus and tubes and patency of tubes.

Can a person have two different tube test report at different occasions.
Many times on sudden instillation of dye the tubal openings undergoes sudden spasm as a result sometimes one or both tube may appear blocked on X-Ray at the starting. The tube may appear blocked at the mid-level or at the end due to kinking , mucus block or fibrosis. Out of these fibrosis is an irreversible form of damage but kinking ao mucus block may disappear and tube may appear open at the other instance of HSG.

When to evaluate the male partner?
Abnormal semen parameters are now a common cause of infertility as male infertility is alarmingly on the rise. Sad part is that it is still overlooked commonly and couple loses the precious years wasting money on endless female fertility testing.
Also infections must be ruled out and it is good if all samples go through infection screening.

What are the factors behind an abnormal sperm count?
Sperm and its production can be affected by numerous factors like environmental factors, temperature variations, toxins- pollutants and hectic lifestyle. Hormonal factors, chronic illnesses like hypertension , diabetes etc., any trauma, surgery, childhood diseases like mumps can decrease sperm production .Apart from this varicocele is also a very common cause of variable sperm count.