Infertility tests are performed on the patient or couple in order to determine the source of infertility. Tests may also detect any conditions or abnormalities that may inhibit one or both partner's ability to conceive a child, or lead to birth defects or congenital disorders. The best candidates for infertility evaluation are:
- Couples who are in their mid-30s
- Couples who have not used birth control for six months
- Those who have been trying to conceive for at least a year
- Those with physical problems, such as erectile dysfunction
Infertility issues can be very sensitive, and therefore confidentiality is provided to patients who choose to undergo an infertility evaluation.
It is important for both partners to be tested in order to determine an accurate, complete evaluation of any potential fertility problems. Male infertility is a factor in about 45% of all infertility cases and requires a thorough investigation. Thanks to advances in fertility treatment methods, approximately 60% of couples treated for infertility are able to conceive.
Reasons for Infertility Evaluation
Infertility may be caused by a number of genetic, environmental and physical factors, including:
- Abnormal sperm count or motility
- Hormonal imbalances
- Fallopian tube blockages due to a sexually transmitted disorder
- Varicocele, or varicose veins in the scrotum
- Uterine or cervical abnormalities in size and shape
- Overexposure to pesticides, anabolic steroids, radiation or marijuana
- Damage related to cancer therapy, such as chemotherapy or radiation
In some cases, there may be the possibility of unexplained infertility in both men and women. However, there are fertility treatment options available even in such cases.
Prior to Infertility Evaluation
Before a couple undergoes a series of infertility evaluations, it is advisable to try fertility awareness methods. A woman is most fertile during ovulation and one to two days prior to ovulation. Some couples may find success by using home ovulation kits (such as the home LH urine test) to document menstrual periods and to determine the best time each month for pregnancy attempts.
Initial tests that may be performed on both patients include the following:
- Physical exam, including a Pap test
- A complete medical history
- Blood or urine tests
These tests can rule out any physical, hormonal, or disease-related issues that may inhibit fertility. Other lifestyle factors may also be identified at this time, including previous drug use, intake of caffeine, alcohol, tobacco and other illegal drugs. If a sexually-transmitted disease is suspected, further testing may be performed.
Evaluation of female infertility may involve further testing and diagnosis of hormonal and physical problems. Ultrasound or x-ray imaging may also be performed to further examine the uterus and fallopian tubes for anything that may indicate difficulty conceiving.
- Postcoital test
- Pelvic ultrasound
- Endometrial biopsy
Evaluation of male infertility also involves further testing and diagnosis of hormonal and physical problems, which may include urinalysis and a semen analysis to identify any abnormalities that may lead to infertility; a semen analysis can be ordered by Dr. Rehder. Other areas of testing are available and are done by a urologist, our office can refer you to a specialist for this.
- Semen analysis
- Pelvic ultrasound
- Testicular ultrasound
- Testicular biopsy
After testing is complete, Dr. Rehder will discuss the evaluation results and determine an appropriate treatment. If no conclusive indications are found, additional testing may be performed. The couple should discuss all fertility treatment options with the physician in order to determine the best approach.