Fertility Investigations, Ovulation Induction & Preconception Counselling

We recommend a structured fertility evaluation if a couple has not conceived after 12 months of regular unprotected intercourse, or after 6 months if the female partner is aged 35 years or older, or immediately if there is a known history of irregular cycles, endometriosis, pelvic inflammatory disease, or previous ectopic pregnancy.

Rather than ordering unfocused tests, Dr Tebo Rasenyai follows a logical diagnostic pathway that evaluates the three essential pillars of natural conception: regular ovulation and ovarian reserve, a healthy uterine cavity and patent fallopian tubes, and normal semen parameters.

• Ovulatory & Endocrine Profiling: Cycle day 2–3 basal hormones, Anti-Müllerian Hormone (AMH), thyroid function, prolactin, and mid-luteal progesterone confirmation of ovulation.
• Uterine & Tubal Evaluation: High-resolution transvaginal ultrasound, Hysterosalpingography (HSG) or diagnostic laparoscopy and dye perturbation (chromopertubation) to confirm fallopian tube patency.
• Male Factor Assessment: Coordination of accredited laboratory semen analysis for the male partner.

Because male factor subfertility contributes to approximately 40% of couple subfertility, we encourage both partners to attend the initial fertility consultation where possible. Evaluating both partners simultaneously prevents months of delayed diagnosis.

When structural barriers to implantation or tubal transport are identified — such as submucosal fibroids, endometrial polyps, intrauterine adhesions, hydrosalpinx, or endometriosis — Dr Rasenyai performs minimally invasive hysteroscopic or laparoscopic surgery at Clinix Victoria Private Hospital to optimise reproductive anatomy.

For women with anovulatory cycles (such as PCOS or hypothalamic ovulatory dysfunction) and patent fallopian tubes, monitored oral ovulation induction (using letrozole or clomiphene citrate protocols) is a safe, effective first-line fertility treatment.

Dr Rasenyai performs serial transvaginal follicular tracking ultrasounds around cycle days 10 to 14 to measure dominant follicle growth and endometrial trilaminar thickness, advising couples on the precise fertile window for timed intercourse or triggering ovulation when the lead follicle reaches maturity.

A dedicated preconception consultation is invaluable for women planning a pregnancy who live with chronic hypertension, diabetes mellitus, epilepsy, thyroid disease, autoimmune conditions, or a history of previous adverse pregnancy outcomes.

During a preconception visit, we review and transition any teratogenic chronic medications to pregnancy-safe alternatives, optimise HbA1c and blood pressure control, verify rubella immunity, and initiate appropriate folic acid dosage before conception occurs.