Fertility Evaluation – What you should know
When a couple is unable to become pregnant or conceive after 1 year of unprotected, natural sexual intercourse; it could be a case of infertility. The age of the woman is an important factor in this too. As reports of infertility in India and abroad are becoming quite common, health seekers must remember the fact- that there are solutions for the issues, but have a thorough evaluation done before jumping to any conclusions. The doctor you consult will usually recommend tests for both the male and female.
A standard fertility evaluation consists of a series of tests for both men and women like thorough physical exams, blood sampling and medical and sexual histories of both partners.
Women: The first thing a doctor checks is to see whether ovulation is occurring in the woman. This is determined through 1) blood tests that identify hormones, 2) ultrasound scans of the ovaries, or sometimes a home ovulation test kit. Women who have an irregular menstrual cycle have a higher likeness of ovulation problems. Most doctors also say that it is possible for a woman with regular periods to have an ovulation disorder.
When it is confirmed that the woman is ovulating, doctors will then advise a test called the hysterosalpingogram. This is a type of X-ray of the uterus and fallopian tubes; and multiple X-rays are taken. A dye is used in this process and if the fallopian tubes are open, the dye flows through the tubes and will be seen in the abdominal cavity. In the case of blocked fallopian tubes, the dye will remain in the uterus or fallopian tubes, revealing the location of the blockage.
An ultrasound examines the female reproductive structures and a hysterosonography is a more complicated type of ultrasound that involves saline going into the uterus during the exam. A hysterosonography can help to identify if fibroid tumours are present.
Men: The doctor will begin by taking a full medical (trouble with ejaculation, if any) and reproductive history, along with any surgeries you have undergone, medications you are taking and your lifestyle (eating habits, smoking, drinking, etc.). Then the doctor will prescribe a semen analysis test which will evaluate the man’s sperm count, sperm movement and structure. Sometimes it isn’t easy to state a specific reason for a sperm disorder. Experts say no sperm or very low sperm can be related to genetics.
If there is no problem with the sperm, it could be that there exists a blockage which can be fixed with surgery. Concerns such as absence of the main sperm pipeline (vas deferens), is a genetic problem that some men are born with. There could also be some obstruction between the testicles and the penis, the presence of anti-sperm antibodies, and varicoceles (one of the most common causes of correctable male infertility today).
Remember not to speculate or assume you are infertile. Talk to the experts at the S10 Health SafeCare Network and meet with a specialist today!
MBBS, DGO, DNB (OG), Dip. ALS (Germany), AMRCOG (UK),
Medical Director - GBR Clinic – Fertility Centre