How is Infertility Diagnosed?
Originally posted 2023-05-04 11:29:59.
Doctors look at men and women in different ways to figure out if they can have children.
Evaluating Female Fertility
A health care provider will ask a woman specific questions about her health history to figure out if she is fertile. These things are:
- Prior pregnancies
- Prior miscarriages
- How often does her period come every month?
- having pain in the pelvis
- Whether she has unusual bleeding or discharge from the womb
- Whether she has had pelvic infections or pelvic surgery before
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A pelvic exam or pelvic ultrasound, a Pap test, and blood tests can all be part of the first screening. The health care provider may look for signs of milk production in the breasts, which could indicate a hormone imbalance, as well as other physical signs of polycystic ovary syndrome and other conditions that affect fertility.
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A doctor or nurse can also do the following tests and evaluations in the lab:
- A blood test can tell how much of a hormone called progesterone a woman has on the 23rd day of her period. This test can tell if ovulation has happened and how much of this hormone the ovaries are making.
- Other hormones critical for fertility may also be tested. How many eggs a woman has left can be approximated by the levels of two substances in her blood, called follicle-stimulating hormone (FSH) and anti-Müllerian hormone (AMH). FSH makes eggs, and a hormone called estradiol makes more of it. High FSH levels may indicate a woman’s ovaries have shut down because of perimenopause, menopause, or that she is has an ovarian cause of primary infertility. If a woman’s FSH is low, it might indicate she stopped making eggs. AMH is produced only in ovarian follicles, so the level of AMH in the blood indicates that new follicles are developing.
- Other tests may involve examination of the fallopian tubes to check if there is a blockage that prevents the egg from moving through the ovaries. Among them are the following:
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X-ray hysterosalpingogram (HISS-tuh-roh-sal-PING-goh-gramme) A radiographic dye is pushed through the cervix to fill the uterus. The colour will come off the end of a tube if there are no blockages in the fallopian tubes, and spill out into the peritoneal cavity. X-ray fluoroscopy is employed to observe the travel of the dye.
A laparoscopy is a surgical procedure in which a small viewing tool called a laparoscope is inserted through a cut (incision) in the lower part of the abdomen, and it enables examination of the female reproductive organs. If the test shows that your fallopian tubes are blocked, the blockages can be corrected with tools inserted through the laparoscope.
- A doctor or nurse may look at the inside of the uterus to see if there are scars, uterine fibroids, or polyps. The uterus is checked out in the following ways:
– Ultrasound of the womb uses sound waves to look at organs within your body. The device sends sound waves through the body and into the vagina when a wand is placed there. This provides a doctor with a better view of the uterus, ovaries and other components of the female reproductive system.
Hysteroscopy A hysteroscope is a long, thin camera with a tiny light on the end that’s inserted into your womb through your vagina.
– Saline sonohysterogram A sterile saline solution is injected through the cervix to fill the uterus in this test. With the uterine cavity full, it is easier to visualize the lining of its interior. Pelvic organs can be visualized on transvaginal ultrasound. Concurrently, fluid can collect in the peritoneal cavity and this indicates that there is at least one tube open.
- Health care providers sometimes test a woman over age 35 to find out how many eggs she has or whether her egg is ready to be released. For this test, a health care professional uses a transvaginal ultrasound to view the ovaries and checks levels of certain hormones in the blood on specific days of the menstrual cycle.
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Evaluating Male Fertility
In order to figure out if a man is fertile, doctors look for signs of hormone deficiency, such as increased body fat, less muscle mass, and less hair on the face and body. There are also questions about the man’s health history in the evaluation, such as:
- Past injury to the testicles or penis
- Recent high fevers
- Childhood diseases, such as mumps
- Low sexual desire (libido)
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A physical examination of the testicles and penis can help find problems like:
- Infection, signalled by discharge or prostate swelling
- Hernia
- Malformed tubes that transport sperm
- Hormone deficiency, as indicated by small testes or a lack of facial and body hair
- presence of a mass in the testicles
- Varicocele (abnormal veins in the scrotum)
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A doctor or nurse may also ask a man to give a sample of his sperm so they can see how healthy and good they are. For a man to give a sample of his sperm, he must not ejaculate for about 48 hours before the test. He then gives a sample by either masturbating into a cup or having a sexual encounter with a special condom that collects sperm without hurting them. A man may need to give more than one sample of sperm because the amount of sperm he makes changes over time depending on his health, activities, and stress level.
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Some other tests could be:
- Hormones in the blood, such as testosterone, follicle-stimulating hormone, thyroid hormones, and prolactin, are measured. A testicle biopsy is also done. A needle is used to get sperm out of the testicle by a health care provider.
- Testing for genes. Before starting fertility treatments, a health care provider may do genetic testing if there are no or very few sperm in the sperm. Testing can find problems with the chromosomes that could lead to a lack of sperm or problems with how children grow and develop.
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FAQs on “How is Infertility Diagnosed?”
No pregnancy after having regular, unprotected vaginal intercourse for 12 months (six months if the woman is over the age of 35) is generally we consider infertility.
Testing typically comes after 12 months of trying without a pregnancy, or earlier if there are risk factors known to make it hard to conceive, like irregular periods, prior fertility problems or medical conditions that affect fertility.
Typically, both individuals are tested since the inability to conceive can result from either the male or female partner and is sometimes a result of unknown factors.
Infertility is frequently diagnosed in gynecological, andrological or fertility consultation among which partner and when symptoms.
The doctor will generally take a comprehensive medical, sexual and lifestyle history inquiring about menstrual cycles and prior pregnancies, surgeries, illnesses and medication.
Such tests may include a blood test for hormones, pelvic ultrasound and imaging of the uterine cavity and fallopian tubes to assess their shape and whether they are open.
The primary test is semen analysis which evaluates sperm count, ambient movement of sperm, shape and volume. Blood tests for hormones or physical exam may also be required.
Yes. Often, smoking status, alcohol use, body weight and exposure to stress are also discussed as these health behaviours might affect reproductive health.
That may take from a few weeks to a few months, depending on which tests are needed and how quickly results can be returned.
Yes. All of the test results may be normal and still pregnancy does not occur. This is called unexplained infertility.
