Infertility Diagnosis and Testing
Reproductive Sciences Medical Center is the leader in infertility solutions. Many fertility centers don’t take the time to correctly diagnose a couple’s infertility. They’ll immediately recommend costly and time-consuming treatments, when only basic fertility treatment might be necessary. At Reproductive Sciences Medical Center, our doctors recommend a customized set of diagnostic tests after they’ve been evaluated.
In the United States, approximately 6% of couples who want to get pregnant either cannot conceive or are unable to carry a pregnancy to term. The numbers break down as follows:
- One-third are due to female infertility,
- One-third are due to male fertility,
- Both partners infertility attribute to the remaining third
How is Female Infertility Diagnosed?
If a woman under 35 is unable to conceive after a year of unprotected sex, or 6 months if she’s over 35, then it may be time to consider infertility tests. Health care providers may utilize different diagnostic exams along with her medical history.
- Ovulation Testing: Doctors may run a blood test to measure progesterone levels. This will determine if enough is being produced and if ovulation has occurred.
- Hormone Testing:There are a variety of hormones associated with reproduction. We may test for levels of follicle stimulating hormone (FHS) and anti-mullerian hormone (AMH) to determine a woman’s remaining egg supply. High FHS may indicate ovarian failure or perimenopause. Low FSH levels may indicate reduced egg production. While AMH indicates the presence of growing follicles.
- Hysterosalpingography: a contrast dye is injected into the uterus and an X-ray is taken to detect abnormalities in the uterine cavity. This examination will determine whether there is a blockage in the fallopian tubes that prevents movement of the egg from the ovaries.
- Laparoscopy: this is a surgery that involves utilizing a laparoscope, a small viewing instrument, to examine the female reproductive organs for blockages.
- Ovarian Reserve Testing: a series of blood and imaging tests that help determine the quality and quantity of eggs available for ovulation. This test is usually reserved for women over 35 who are more likely to have a low ovarian reserve.
- Transvaginal Ultrasound: A type of ultrasound used to transmit images of your pelvis. It will check for scarring, uterine fibroids, and polyps. This may be recommended by your healthcare provider.
- Hysteroscopy: A hysteroscopy may also be used to determine if there is scarring, uterine fibroids, or polyps in a woman’s uterus. A long camera is inserted into the vagina and its feed appears on a monitor for examination.
How is Male Infertility Diagnosed?
Men are usually checked for fertility problems at the same time as their female partner. Age does not play as much of a factor in male fertility as it does in female fertility since men continually produce new sperm from the time they hit puberty to old age. The following are used for initial examinations.
- Physical examination: a physician will examine the testes and penis to identify any issues such as hernia, infection, and hormone deficiency that may affect fertility.
- Urinalysis: will check for infection.
- Semen evaluation: used to assess sperm motility, the shape and maturity of the sperm, the volume of the ejaculate, the sperm count and the liquidity of the ejaculate.
- Hormonal tests: evaluate levels of testosterone, thyroid hormones, prolactin and FSH, so the overall balance of the hormonal system can be determined.
Generally, the problem can be diagnosed after the first round of testing. However, if the problem is not obvious after the first round of testing, more advanced testing might be necessary. These tests can include: seminal fructose test, post-ejaculate urinalysis, semen leukocyte analysis, Kruger and world health organization (WHO) morphology, anti-sperm antibodies test, sperm penetration assay (SPA), ultrasound, testicular biopsy, vasography, and genetic testing.