When a fertility check-up finds a treatable issue: one couple’s journey

When a couple have been trying to conceive for more than a year, it is natural to assume that fertility treatment such as IVF may be the next step.

But sometimes, a detailed fertility assessment identifies a smaller, potentially treatable issue that may be contributing to the difficulty conceiving.

That was the case for one couple who came to Harley Street Fertility Clinic in May 2026 after 14 months of trying for a baby without success.

Starting with a full fertility assessment

Mrs H was 32 and Mr A was 37. Neither had any significant medical or surgical history, and there was no obvious explanation for why they had not conceived.

The couple therefore underwent a Couples Fertility Check-Up to assess both partners and look for any factors that might be affecting their fertility.

Mrs H’s investigations showed polycystic ovaries.

Mr A’s semen analysis showed a normal sperm count and normal motility, but borderline morphology, meaning the proportion of sperm with a normal shape was close to the lower end of the expected range.

At this stage, the results did not point to a severe male-factor fertility problem, but they did justify looking a little more closely.

Looking beyond a standard semen analysis

The clinical team recommended that Mr A undergo a Sperm DNA Fragmentation test.

Sperm DNA fragmentation testing looks at the quality and integrity of the genetic material carried by sperm. It can provide additional information in some fertility cases beyond the standard measures of sperm count, motility and morphology.

As part of this process, Mr A’s semen sample was also tested for infection.

That test produced an important finding.

The sample showed a heavy growth of Klebsiella oxytoca, at a level of 10⁵ organisms/ml.

The laboratory testing also showed which antibiotics the organism was sensitive to, allowing Mr A to be prescribed an appropriate course of treatment.

Treating the infection first

Rather than moving immediately towards more advanced fertility treatment, the priority was to treat the infection.

Mr A completed the prescribed course of antibiotics.

One week after finishing treatment, his semen was tested again. This time, no infection was detected.

Only once the infection had cleared did he proceed with the planned Sperm DNA Fragmentation test.

The result was normal.

This was reassuring. It meant that despite the borderline morphology seen on the original semen analysis, there was no evidence of increased sperm DNA fragmentation on the subsequent test.

A natural pregnancy

While these investigations and treatment were taking place, something very welcome happened.

After 16 months of trying to conceive, Mrs H became pregnant naturally.

The couple had originally come to Harley Street Fertility Clinic because they had been unable to conceive for more than a year. Within the course of their investigations, a semen infection had been identified and successfully treated, and shortly afterwards they conceived without the need for IVF.

This case does demonstrate why thorough investigation matters. An infection was identified in a semen sample despite otherwise relatively reassuring sperm count and motility results, it was treated successfully, and the couple subsequently conceived naturally.

Why semen infection can be worth investigating

A standard semen analysis provides valuable information about sperm concentration, movement and shape.

However, in some cases, additional investigations can reveal factors that are not immediately apparent from those headline measurements.

Infections within the male reproductive tract can potentially affect semen quality and may contribute to fertility difficulties. Where an infection is identified, laboratory testing can help determine the appropriate treatment before further fertility investigations or treatment continue.

For Mr A, the infection was not something he had initially been aware of. Without further testing, it may not have been identified.

Fertility treatment does not always mean IVF

This case also illustrates something that is sometimes overlooked when people first approach a fertility clinic.

Harley Street Fertility Clinic provides advanced treatments including IVF and ICSI, but the aim of a fertility assessment is not automatically to move every patient towards assisted reproduction.

The first objective is to understand why a couple may be experiencing difficulty conceiving.

Sometimes that investigation identifies a complex issue requiring specialist fertility treatment.

Sometimes it identifies something much smaller that can be investigated or treated first.

In this case, a Couples Fertility Check-Up led to further male fertility investigation, which identified an infection that could be treated with antibiotics. After the infection cleared, the couple were able to conceive naturally.

The value of investigating both partners

One of the most important lessons from this couple’s experience is the value of assessing fertility as a couple.

Mrs H’s scan identified polycystic ovaries, while Mr A’s semen analysis prompted further investigation.

Had the focus been placed entirely on one partner, a potentially relevant factor affecting the other may have been missed.

Fertility difficulties do not always have a single explanation. Results also do not always fall neatly into categories of “normal” or “abnormal”. Sometimes it is the combination of findings, further testing and clinical judgement that helps determine the most appropriate next step.

At Harley Street Fertility Clinic, our approach is to investigate carefully before recommending treatment.

For some patients, IVF will be the right option. For others, identifying and addressing a smaller issue may be all that is needed before they are able to conceive.

For this couple, careful investigation meant that an unexpected semen infection was identified and successfully treated. Two months after first attending the clinic, and after 16 months of trying for a baby, they discovered they had conceived naturally.

Sometimes, the most important part of fertility care is not starting treatment. It is finding the right problem to solve.