Couples who have been experiencing infertility issues for an extended period of time may choose to undergo an evaluation to determine the cause of their problem with fertility. An infertility evaluation may be performed to determine the source of infertility and diagnostic tests may also be used to detect any conditions or abnormalities that may inhibit one or both partner's ability to conceive a child. Candidates for infertility evaluation may include couples who have been trying to conceive a child for at least one year, couples who are over the age of 35, or couples or patients with certain physical or medical problems that may affect fertility.
During the initial infertility evaluation, both the female and male partner will undergo a full physical examination and their complete medical histories will be reviewed. In addition, blood and urine tests will be performed. Additional tests to determine the cause of infertility will also be performed and may include:
Evaluation For Women:
- Hysterosalpingography to evaluate the condition of the uterus and fallopian tubes
- Hormone testing to check levels of hormones that control reproductive processes
- Ovulation testing
- Imaging tests of reproductive organs
Evaluation For Men:
- Semen analysis
- Hormone level testing to check testosterone levels
- Transrectal and scrotal ultrasound
- Testicular biopsy
- Pelvic ultrasound
Both partners may also be tested for any genetic defects that may be causing infertility.
Treatment of Infertility
Once the cause of infertility is identified, a treatment plan can be created. Treatment for infertility aims to to maximize the couple's fertility potential and allow for successful conception. Recommendations for increasing fertility may be as simple as quitting smoking, avoiding alcohol and losing weight. Treatments may vary depending on the cause and may include:
- Fertility drugs to induce ovulation
- Surgery to repair blocked or damaged fallopian tubes
- Surgery to correct problems with the uterus
- Hormone treatments
- Surgery to correct a varicocle
- Medication to treat impotence
- Sperm retrieval
- Hormone treatments
Intrauterine insemination may also be performed to assist with pregnancy. In this procedure, healthy sperm are implanted directly into the uterus at the time of ovulation through a thin catheter. If these infertility treatments are unsuccessful, the couple may decide to use other assisted reproductive technology options such as in vitro fertilization, intracytoplasmic sperm injection, donor eggs or sperm, or a surrogate.
Many couples may experience physical and psychological stress during infertility treatments, which can be costly, and may not be covered by insurance. The couple should discuss all fertility treatment options with a physician in order to determine the best approach to treat issues of infertility.
- National Institutes of Health
- Centers for Disease Control and Prevention
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- U.S. Department of Health & Human Services
- U.S. National Library of Medicine