The Basics of an Infertility Workup
- Posted on: Nov 21 2013
A basic infertility evaluation consists of gathering a thorough medical history and conducting a medical examination. Your fertility specialist will ask a number of questions to help determine the cause of infertility. Medical, lifestyle, surgical, gynecological and obstetric history will be all be gathered, as well as a complete review of all medical records from former fertility doctors that you have seen.
The physical exam consists of a pelvic exam and possibly an ultrasound designed to reveal any scarring, or abnormalities on the uterus, fallopian tubes or ovaries. Medications that result in ovarian stimulation may be administered for further evaluation. The fertility specialist is able to count antral follicles, which can be helpful in fertility assessment.
Approximately one-fourth of all infertility cases are caused by ovulation disorder. One of the most common types of ovulation problems is known as polycystic ovarian syndrome. This type of condition is usually effectively treated with medication.
Ovarian reserve may also be tested at this time, as it is extremely important for a woman to have viable egg supply in order to be fertile. Blood and ultrasound tests may be required.
The blood tests depend on the couple’s situation and infertility findings. More than one blood test may be required, with possible testing on both the female and male partner.
Some of the possible blood tests required may be luteinizing hormone, prolactin, testosterone, progesterone, thyroxin, thyroid stimulating hormone or TSH and FSH. If there is a history of recurrent failed pregnancies or miscarriages, further blood tests may be required.
A semen analysis is a critical component to the basic infertility work up and should be done early on in the evaluation process. When there is a sperm defect, testing on the female partner may be modified due to findings.
Therapy can be directed to the problematic sperm and the focus put on the male partner. Approximately 25-30% of infertility cases are caused by a sperm defect.
HSG stands for hysterosalpingogram and is conducted in order to evaluate the endometrial cavity, uterus and fallopian tubes. If a tubal factor is suspected, HSG may be needed for proper assessment and diagnosis. Approximately 25 percent of all infertility patients experience a tubal factor.
Once the basic testing is complete, a laparoscopy procedure may be required. This is a surgical procedure that can be used to assess pelvic scar tissue, endometriosis or other damage that may be causing infertility. Laparoscopy is an invasive procedure and should only be done after all other treatments fail to provide favorable results.
An infertility workup is an individualized regimen of exam and testing designed to obtain the highest success possible with subsequent treatments. Dr. Deborah Smith has been voted multiple times the Top Fertility Doctor in Colorado, and offers comprehensive options that are both conservative and operative.
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