The joy of parenthood is a challenge for many couples. Approximately 10-15% of couples in the U.S. are infertile. Infertility is the inability to become pregnant despite having frequent sexual intercourse for one year. Infertility can be related to a single cause in your partner or yourself, or it can be related to a combination of factors. Fortunately, many effective, safe therapies are available to help couples overcome infertility.
The Female Infertility Evaluation
Most women are advised to try to conceive a full year before beginning fertility testing. However, for women over the age of 35 years, and people who have known medical problems that could affect fertility, earlier testing is appropriate. Experts estimate that around 40% of infertility cases is attributed to a female factor. The basic evaluation for women with infertility includes a medical history and physical examination. Additional testing is used to further refine the diagnosis. A careful review of each symptom can include:
- A review of the menstrual cycle pattern to determine if ovulation is occurring, or if other problems exists, such as uterine defects (fibroids or polyps) or a diminished egg reserve (related to aging).
- Collection of information that could suggest an anatomic problem of the fallopian tubes, including questions regarding history of sexually transmitted diseases, previous abdominal surgery, and /or painful sex or periods.
- Questions about previous surgery to the uterus or cervix, such as freezing for abnormal Pap tests.
- A detailed social history to evaluate for environmental exposures or social habits, including alcohol use, smoking, extreme exercise, or drug usage.
- A general review of systems, which includes questions about symptoms related to endocrine dysfunction.
To evaluate the pelvic structures and assess for possible hormonal problems, the physical examination is done. Additional hormone level testing and ultrasounds are required to assess ovarian age and ovulation. Ovarian reserve testing determines the quantity and quality of the eggs, and hormone tests check levels of ovulatory hormones. A hysterosalpingogram (HSG) is a special x-ray test used to evaluate the uterus and fallopian tubes. When serious damaged to the reproductive organs is suspected, a surgical procedure (hysteroscopy or laparoscopy) can be performed.
The Male Infertility Evaluation
Around 40% of couples have infertility due to a male factor. Evaluate of the male is significant for the development of a comprehensive treatment plan for the infertile couple. The initial male infertility workup includes a medical history, physical examination, semen analysis (one or more), and hormone level testing. The initial evaluation includes:
- A review of past surgeries, medications used, and health problems.
- Inquiry into family history of birth defects, infertility, and problems associated with the reproductive system.
- A detailed review of occupational hazards, social history, and personal history to evaluate exposure to any substances or toxins that could impact fertility.
The physical examination involves an evaluation and inspection of the penis, testes, scrotum, and prostate. Laboratory tests are conducted, including a urinalysis to assess for infection. The semen analysis is done to assess sperm movement (motility), number of sperm (sperm count), shape of sperm, and if or not the sperm are mature.
Hormone testing evaluates levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and testosterone to determine if a problem exists that could affect sperm production. A transrectal ultrasound and scrotal ultrasound are done to help the doctor check for ejaculatory duct obstruction and retrograde ejaculation. In addition, a testicular biopsy could be done to see if sperm production is normal.
PRC Fertility Center in Dubai is a first rate clinic for comprehensive workup and treatments to help women achieve their fertility goals. Patients are treated by Board Certified fertility specialists in the Middle East with compassion, expertise and diligence. Call now!