Let's be clear, infertility is a disease. It is defined as the inability to achieve a pregnancy after a year or more of regular, unprotected sexual activity. Eighty five percent of couples who are going to achieve a pregnancy without help get pregnant within 1 year.
You should seek evaluation and treatment after 6 months of attempting pregnancy if you are a woman who:
If you are having trouble conceiving, you are not alone. Infertility affects 6.1 million people in the United States. That's about 1 in 8 couples who will have trouble with infertility sometime in their lives. What's more interesting is that infertility plays no favorites, impacting men and women equally. Roughly 30% of the time, causes are linked to the woman and 30% are linked to the man. Another 30% is attributed to factors in both the man and woman, with the remaining 10% determined to be of unknown causes.
A fertility evaluation will answer four basic questions:
To answer these questions, specific tests are ordered.
1. Do we have sperm?
A semen analysis is a quick and simple way to determine if sperm are present and to determine their numbers, shape (morphology), and swimming ability (motility). If a previous test from another lab shows an abnormal result, our Andrology Lab will repeat the semen analysis using Kruger strict criteria to determine if the sperm’s ability to fertilize an egg is compromised or normal.
2. Do we have eggs?
Typically a woman who develops and ovulates an egg each month will have a regular menstrual cycle. Lab tests, such as AMH (anti-Mullerian hormone) and FSH (Follicle Stimulating hormone), indicate adequate ovarian reserve or number of remaining eggs in the ovary.
3. Can the sperm and the egg meet?
For fertilization to occur an egg and sperm must be able to meet in the fallopian tube. Damage or obstruction of the fallopian tubes prevents fertilization from happening. A Hysterosalpingogram (HSG) can determine if the fallopian tubes are open.
4. Is there a healthy environment to nurture the embryo/fetus?
The HSG test, mentioned above, also visualizes the shape of the interior of the uterus. Fibroids or polyps (growths) in the uterine cavity can interfere with the implantation and development of a fertilized egg (embryo) by changing the shape of the uterus.
Additionally, blood tests that evaluate thyroid function (TSH) and Prolactin hormone levels are performed as these hormones can affect ovulation as well. Depending on your unique situation, additional blood work or other testing, such as a diagnostic laparoscopy for endometriosis, may be ordered to further clarify treatment options.
Causes of Infertility
These are the most often factors causing infertility in couples.
Besides a review of your past medical and family history, we might order some tests to get a diagnosis.
Get more information about possible treatment options for fertility.