Infertility Diagnosis and Testing
San Diego’s outstanding fertility center, Reproductive Sciences Medical Center offers the leading infertility doctors. Many fertility centers spend too little time determining the correct diagnosis for a couple’s infertility, immediately recommending costly, time-consuming treatments when only basic fertility treatment might be necessary. At Reproductive Sciences Medical Center, each couple is individually evaluated and only then is a customized set of diagnostic tests ordered for them.
In the United States, approximately 6% of couples who want to get pregnant either cannot conceive or cannot carry a pregnancy to term. This breaks down to:
- one-third of these cases are due to female infertility,
- one-third are due to male infertility,
- one-third of these case include infertility in both partners or attributed to unknown causes
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 the progesterone levels. This will determine whether ovulation has occurred and whether the ovaries are producing a typical amount.
- Hormone Testing: there are a variety of hormones associated with reproduction. A health care provider may test for levels of follicle-stimulating hormone (FSH) and anti-Mullerian hormone (AMH) to determine a woman’s remaining egg supply. High FSH may indicate ovarian failure or perimenopause or menopause, while low FSH levels may indicate reduced egg production. AMH in the blood may indicate 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 pelvic ultrasound where an ultrasound wand is inserted into the vagina to deliver sound waves and eventually transmit images of the inside of your pelvis. This checks for possible scarring, uterine fibroids, and polyps, a health care provider may suggest a transvaginal ultrasound.
- Hysteroscopy: A hysteroscopy maybe used to also determine if there are scarring, uterine fibroids, or polyps in a woman’s uterus. A long camera is inserted into the vagina and its feed is 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.