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Areas of care · Van

Infertility & Reproductive Health

Assessment for couples wishing to conceive, investigation of possible causes and an individual plan.

Every journey is individual.

Every fertility journey is different. Your health history, previous investigations and priorities are considered together. The consultation creates space for your questions and helps identify appropriate next steps.

Infertility (in everyday terms, not being able to get pregnant) is a matter for the couple: we investigate the causes together and shape the plan around you.

Op. Dr. İhsan Rua

Who it is for

Couples who have not conceived despite unprotected intercourse for 12 months under the age of 35, or for 6 months at 35 and over.

At the consultation

Medical history, examination and any necessary tests; assessment of the male partner is part of the process.

Next step

An individual plan based on the results; if needed, counselling on assisted reproduction (the practice is not an IVF centre).

Areas of assessment

  • Female infertility and possible causes
  • Ovulation difficulties and tracking
  • Polycystic ovary syndrome (PCOS)
  • Preconception assessment
  • Recurrent pregnancy loss
  • Fertility treatment counselling
  • Assisted reproduction counselling

What happens during the consultation?

At your first consultation, your health history, current concerns and expectations are listened to. You can bring previous test or examination results. After the necessary assessments, the options suitable for you and a follow-up plan are discussed together.

  1. Consultation and medical history
  2. Examination and necessary tests
  3. Individual plan; referral to relevant specialists when needed

Limits and evidence

  • In unexplained infertility, a period of monitoring is recommended first, then ovarian stimulation and insemination, and the IVF step last.2,3
  • For most additional procedures in IVF (add-ons), there is no high-quality evidence. The practice is not an IVF centre; it provides counselling for this step.8

Frequently asked questions

We can’t get pregnant; when should we see a doctor?

If pregnancy has not occurred despite regular unprotected intercourse for 12 months under the age of 35, or for 6 months at 35 and over, an assessment is recommended. Over the age of 40, or if there is a known risk factor such as irregular periods, previous pelvic surgery or suspected endometriosis, you can seek assessment without waiting.1

Does infertility depend only on the woman?

No. A male factor plays a part in a significant proportion of couples; for this reason, it is recommended that the male partner is also assessed, with a history and semen analysis, from the first visit.1

Which tests are done during the assessment?

The basic assessment looks for answers to three questions: is ovulation taking place, are the fallopian tubes open, and is the semen analysis normal? Ovarian reserve tests and a pelvic ultrasound are added to this; which tests are needed is decided according to your history and examination.1,9

What does “unexplained infertility” mean?

It means that pregnancy does not occur even though the standard tests are normal. Current guidelines recommend a period of monitoring first, then ovarian stimulation with insemination, and the IVF step last; the order and timing are decided together, according to the couple’s age and how long they have been trying.2,3

I have polycystic ovary syndrome; can I get pregnant?

Yes, most women with PCOS can get pregnant. PCOS is the most common cause of ovulation disorders; lifestyle changes and ovulation induction with the first-line medicine set out in the guideline are the starting point of treatment. Which option is right for you is decided at the examination.5,6

I have had two miscarriages; is investigation needed?

Recurrent pregnancy loss is defined as two or more pregnancy losses, and investigation is recommended at this point. The current guideline sets out an evidence-based framework for investigation and treatment; emotional support is also part of care.4

Do frequency of intercourse and position matter?

During the fertile window, intercourse every one to two days gives the highest chance of pregnancy; two to three times a week comes close to this. Position, orgasm and lying on your back after intercourse have not been shown to affect the chance of pregnancy.7

Sources

  1. ACOG CO 781 (2019) (opens in a new tab)
  2. NICE NG257 (2026) (opens in a new tab)
  3. ESHRE Unexplained infertility (2023) (opens in a new tab)
  4. ESHRE Recurrent pregnancy loss (2023) (opens in a new tab)
  5. International PCOS Guideline (2023) (opens in a new tab)
  6. TJOD PCOS Guideline summary (in Turkish) (opens in a new tab)
  7. ASRM Optimizing natural fertility (2022) (opens in a new tab)
  8. ESHRE add-ons (2023) (opens in a new tab)
  9. ASRM Fertility evaluation (2021) (opens in a new tab)

This information is educational and is not a personal diagnosis or treatment recommendation. Assessment and follow-up are tailored to you during a medical consultation.

Health Library

All articles on this topic
Infertility3 min read

Ovulation and fertility: What happens at an initial assessment?

Basic information about the timing of assessment when planning a pregnancy, the limits of ovulation tracking and why it is important for the couple to be assessed together.

Infertility7 min read

What to Know Before IVF: Counselling, Timing and Realistic Expectations

Right timing, counselling and realistic expectations before IVF: the step-by-step approach in current international guidelines, and add-ons with weak evidence.

Infertility6 min read

Polycystic Ovary Syndrome and Pregnancy: How Is Ovulation Tracked?

With polycystic ovary syndrome, pregnancy can usually be achieved naturally or with treatment. Ovulation tracking and treatment steps, from the 2023 guideline.

Infertility7 min read

We Can’t Get Pregnant: How Does an Infertility Assessment Begin?

A guide based on clinical guidelines for couples who cannot conceive: when does the assessment begin, which three questions does the first examination look at, and why is the man assessed from the start?

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