Women’s infertility should be evaluated if she has not conceived after 12 months of regular, unprotected intercourse. After six months, women over the age of 35 who have one of the following in their medical history or physical examination should be evaluated earlier:
- History of irregular menstrual cycles (over 35 days apart or no periods at all)
- Known or suspected problems with the uterus (womb), tubes, or other problems in the abdominal cavity (like endometriosis or adhesions)
A variety of diagnostic tools are available to assist in determining the cause of infertility. A fertility doctor will recommend specific diagnostic tests after a couple has been evaluated through a comprehensive physical exam and medical history. There are many treatment options for infertility, including medications to correct hormonal issues, surgery for physical problems and in vitro fertilization (IVF).
INFERTILITY DIAGNOSIS
When testing for infertility, doctors will first perform a physical examination and ask questions to learn more about the patient’s medical history and lifestyle. Additionally, one or more of the following tests may be recommended:
Blood Test
A blood test is used to check the patient’s overall health, to check for HIV and see if there are any underlying infections that could be interfering with fertility. Hormone levels are also checked using blood tests. A blood sample can be taken at any point during the menstrual cycle for this purpose.
BBT Charting
When trying to conceive, doctors usually advise that you record your basal body temperature. Ovulation is indicated by a rise in BBT, which can be used to determine the best time for sexual intercourse. This charting can be done from the comfort of your own home.
Ovulation Testing
It is the primary infertility diagnosis done in the form of a follicular study (repeated trans-vaginal scans around the period of ovulation) to confirm the presence and pattern of ovulation.
Postcoital Test
A couple may be advised to engage in unprotected sexual activity and then return to the doctor a few hours later. The doctor will then take a sample of cervical mucus for testing in order to learn more about how sperm cells interact with the mucus. This test can also be used to check the motility of sperm.
Ultrasound Exam
Unlike a standard external ultrasound, this procedure requires the insertion of a special device into the vaginal canal. It projects an image of the uterus and other reproductive organs onto a screen using high-frequency sound waves. The doctor can then determine if there are any structural issues, such as fibroids, that are interfering with pregnancy. This procedure is painless and is usually performed two weeks prior to the patient’s menstrual period.
Hysterosalpinogram
HSG is used to check for fallopian tube blockages as well as uterine defects. A liquid dye is injected into the uterus through the vaginal canal. The dye’s progress through the fallopian tubes is then monitored using a series of X-ray images. The dye will not be able to pass through if there is an obstruction or blockage.
Hysteroscopy
Hysteroscopy is the procedure of inserting a thin, flexible telescope-like device into the uterus through the vaginal canal. Doctors can use this device to look inside the uterus and check for structural issues.
It is not necessary to carry out all of the tests listed above. There may be no identifiable cause of infertility even after testing in some cases. In order to achieve the best results, each woman’s infertility assessment should be tailored to her specific circumstances.
