Your fertility is shaped by a complex interplay of hormones, anatomy, genetics, lifestyle, and age – and understanding it can feel anything but straightforward. Whether you are just beginning to ask questions or have been on this journey for some time, you are not alone, and you do not have to navigate it without support.
With a background in gynaecology, Dr Mandana Master is a specialist in female fertility, combining clinical expertise with a genuinely patient-centred approach to help you navigate every stage of your fertility journey with clarity, compassion, and confidence.
Female infertility has many possible causes, and in some cases more than one factor may be at play. Understanding the underlying cause is the essential first step toward effective treatment.
In some cases, standard investigations do not reveal a clear cause – a diagnosis known as unexplained infertility. This can be frustrating to receive, but it does not mean nothing can be done. Review and more thorough investigation with an experienced fertility specialist often uncover factors that were initially missed, or can help to guide fertility treatment options.
Advancing age is the most common cause of declining fertility among women, as the number of eggs remaining and the quality of those eggs naturally decreases with age. Older age can make it more difficult to conceive, increase the risks of pregnancy complications, and also reduce the likelihood of success with fertility treatment.
Problems with ovulation are among the most frequent causes of female infertility. These include polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS), a hormonal condition affecting how the ovaries function, as well as thyroid dysfunction, which disrupts the hormone balance needed for regular ovulation. Premature ovarian insufficiency (POI) – where the ovaries stop functioning normally before the age of 40 – also falls into this category.
Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, commonly on the ovaries, fallopian tubes, or surrounding pelvic structures. It can interfere with ovulation, fertilisation, and embryo implantation, and is found in a significant proportion of women investigated for infertility.
Blocked or damaged fallopian tubes prevent sperm from reaching an egg, or a fertilised egg from travelling to the uterus. This is often caused by previous pelvic infections (including sexually transmitted infections), prior abdominal surgery, or endometriosis.
Fibroids, polyps, scarring and adhesions, or abnormalities in the shape of the uterus can interfere with embryo implantation or increase the risk of miscarriage. Some structural issues may be present from birth (that is, a congenital abnormality) while others develop over time.
Thyroid disorders, hyperprolactinaemia (elevated prolactin levels), and other hormonal irregularities can disrupt the menstrual cycle and impair fertility, even when other reproductive structures are entirely healthy.
Effective treatment begins with accurate diagnosis. Dr Mandana takes a thorough, individualised approach to investigation, ensuring that her treatment recommendations are based on a complete understanding of your unique circumstances.
To assess ovarian reserve through anti-Müllerian hormone (AMH) testing, thyroid function, prolactin levels, and other key reproductive hormones.
To evaluate the uterus, ovaries, and antral follicle count (another indicator of ovarian reserve).
An X-ray procedure to assess the shape of the uterine cavity and the openness of the fallopian tubes.
A minimally invasive procedure to directly visualise the inside of the uterus and identify or treat polyps, fibroids, or structural abnormalities.
Keyhole surgery that allows direct examination of the pelvis, and is often used to diagnose and treat a wide range of gynaecological conditions, including endometriosis and pelvic adhesions.
Such as letrozole or clomiphene to stimulate ovulation, or hormonal therapies to address conditions like PMOS, thyroid disorders, or hyperprolactinaemia.
To remove fibroids or polyps, treat endometriosis, or repair fallopian tube damage where possible.
addressing weight, metabolic health, and other modifiable factors that can meaningfully impact fertility outcomes.
These interventions may be enough to help you to conceive naturally. However, even if natural conception is not likely after addressing underlying infertility causes, undergoing the appropriate treatments can improve your chances of success with assisted reproductive technologies.
In vitro fertilisation (IVF) is one of the most well-established and effective assisted reproductive technologies available. It involves stimulating your ovaries to produce multiple eggs, retrieving those eggs, fertilising them with your partner’s or a donor’s sperm in a laboratory setting, and transferring one of these resulting embryos into your uterus for pregnancy.
IVF can be particularly beneficial for women with blocked or severely damaged fallopian tubes, endometriosis, diminished ovarian reserve, unexplained infertility, or recurrent implantation failure.
It is often recommended when other more conservative approaches have not been successful, or when the nature of the fertility concern makes natural conception unlikely.
IVF may also represent a meaningful pathway to parenthood for individuals or couples using donor sperm or eggs, and for those looking to preserve fertility through embryo freezing.
A variation of IVF in which a single sperm is injected directly into an egg. It is typically used when there are also male factor concerns, or in cases of prior unsuccessful fertilisation with IVF.
A less invasive procedure in which prepared sperm is placed directly into the uterus around the time of ovulation. IUI may be appropriate for women with ovulatory disorders, mild endometriosis, or unexplained infertility, and is often considered before proceeding to IVF.
Involves the use of medications to stimulate and regulate ovulation, often combined with timed intercourse or IUI. This is frequently a first-line treatment for women with PMOS or other ovulatory dysfunction, and can be highly effective with appropriate monitoring.
Dr Mandana will discuss all relevant options with you in detail, helping you understand the benefits, success rates, and limitations of each approach so that you can make informed decisions about your care.
If you need specialist advice and care for achieving your family building goals, you’ve come to the right place. Get in touch with Dr Mandana Master at Embrace Fertility today.
