Infertility Evaluation Visit

Infertility has many causes. Most of the reasons for a couple’s infertility can be treated. The first step is for the couple to be evaluated so that a diagnosis can be made. The diagnosis will answer the question: Why can’t we get pregnant? Once the why is answered, the how is easier to answer too.

What to expect during the evaluation stage:

    1. The female and male may both be asked to undergo physical examinations. They will also be asked about their medical and sexual histories.

    2. The male will be asked to submit to a semen analysis (SA). This is to determine how healthy the sperm are, as well as how mobile they are. There will also be a sperm count.

    3. A determination will be made regarding if the female is ovulating or not. To determine this a blood test will be conducted during her cycle. The blood test is used to detect hormones that are present during the menstrual cycle and can indicate whether or not ovulation has taken place.

    4. The female can use an ovulation kit to predict when she is likely to ovulate.

    5. Ultrasound examinations can also be conducted to evaluate the ovaries.

    6. If there does not appear to be any ovulation problems then a hysterosalpingogram, which is a type of x-ray of her fallopian tubes and uterus will be done to check the condition of the uterus and fallopian tubes. Dye will be placed to flow through the tubes to check to see if the tubes are open, or if they are blocked. If they are blocked, there is little likelihood of sperm meeting the egg and this is one possible cause for the couples infertility. There may be more than one cause, so a through examination will be conducted.

    7. A special ultrasound called a Hysterosonography can be used to reveal abnormalities such as tumors or irregularities of the uterine cavity.

    8. A laparoscopy can also be done, which is a minor surgical procedure. This will allow doctors to see the abdominal cavity, fallopian tubes and the uterus. This is not just a diagnosis tool, but can be a treatment too. When endometriosis or adhesioins are discovered they can be treated during the laparoscopy.

    9. There is something called “ovarian reserve”, which basically means that there are eggs available in large enough quantity for the female to become pregnant. At age 35 there are some women who still have large enough ovarian reserve to become pregnant where others who are also 35 have already depleted their ovarian reserve. The way doctors can test to find out what the females ovarian reserve is, is to take a blood test on day 3 of the womans menstrual cycle. The test will tell whether or not the numbers are normal. If in the normal range it does not guarantee that the woman can get pregnant. If the numbers are abnormal than it indicates that there is a fertility problem regarding the lack of eggs needed to become pregnant.

There are also tests that can be conducted that will give clues as to how the egg and sperm react. These tests reveal how the immune system of the man and woman react to the sperm. There is a possibility that either the mans or the womans immune system reacts to the sperm as if it were a hostile foreign invader, in which case conception would be unlikely.

Any one or more of these tests and evaluations could reveal abnormalities that could lead to a diagnosis.