Fertility Evaluation in Lebanon: When to Start and What to Expect

The classical definition of infertility is 12 months of regular unprotected intercourse without conception (6 months if the female partner is over 35). Earlier evaluation is reasonable if there is a known risk factor.

When to start

• Under 35 — after 12 months trying.
• 35 and older — after 6 months.
• Any age with irregular cycles, prior pelvic surgery, endometriosis, two or more miscarriages, or known male factor — start now.

The workup — both partners, in parallel

• Female: day-3 hormone panel (FSH, LH, estradiol, AMH for ovarian reserve), TSH and prolactin, transvaginal ultrasound for antral follicle count and uterine cavity, hysterosalpingography (HSG) to check tubal patency.
• Male: semen analysis (preferably two samples 2–3 weeks apart, after 2–5 days abstinence) — single most informative test.
• Both — infection screening, blood group, hemoglobin electrophoresis given regional thalassemia prevalence.

Treatment options

1. Lifestyle — weight optimization, smoking cessation, alcohol reduction, folic acid 400–800 mcg.
2. Ovulation induction (clomiphene, letrozole) ± intrauterine insemination (IUI).
3. In-vitro fertilization (IVF) with or without ICSI.
4. Donor gametes — culturally and religiously sensitive; many Lebanese couples travel for this.

Costs in Lebanon

Initial fertility evaluation 200–500 fresh USD. IVF cycle 3,500–6,500 USD depending on the centre and medication. Insurance coverage for assisted reproduction is limited in Lebanon — most spending is out of pocket.

Choose your clinic carefully

Ask for live-birth rates (not just pregnancy rates) per started cycle, broken down by age group. Ask who does the embryo transfer (consultant or trainee). Verify lab accreditation and incubator quality control.