Fertility Assessment
On the average 15 percent of couples are struggling to have a baby. Infertility is defined as not being able to get pregnant despite having frequent, unprotected intercourse for at least 12 months.
Infertility can affect one or both partners, and the relation is nearly the same. In about one-third of cases, there is an issue with the men, in another one-third with women, and in the remaining cases – with both.
There are many risk factors that might impact on the fertility of both male and female:
- Age
- Tobacco use
- Alcohol consumption
- Weight gain and weight loss
- Lack of physical activity
Not getting pregnant for a long period is the main symptom of infertility. However, it’s not the only one.
A woman is recommended to consult with a doctor in the following cases:
- 35-40 years old woman , who has been trying to conceive for six month or longer
- A woman over age of 40
- Not regular menstruation
- The periods are very painful
- Hormonal problems, such as changes in hair growth or sexual function
- Known fertility problems
- A history of multiple miscarriages
- A woman with endometriosis or pelvic inflammatory disease
- A history of cancer treatment (radiation, chemotherapy or both)
A man is recommended to visit a doctor in the present of the following symptoms or disorders:
- Known problems with sperm
- A history of testicular, prostate or sexual problems
- A history of cancer treatment (radiation, chemotherapy or both)
- Diagnosed varicocele (swelling testicles in the scrotum)
During the first appointment, the fertility physician will ask about the whole medical history and lifestyle. Topics such as birth control use, menstrual and pregnancy history, current and past sexual practices, medications used, surgical history, working and living environment will be discussed.
A thorough physical exam will also be done. A physician will examine the functions of thyroid gland, breasts, look at the hair growth, as well as check the sizes of the pelvic cavity and test pap smear. Pap smear, or pap test, is a procedure to test for cervical cancer in women.
A physician will need the results of some laboratory and radiological tests. It is very important to evaluate ovulation functions: the presence or absence of ovulation (release of the egg from the ovary), the time of ovulation, ovarian function and the uterine function during the ovulation process.
It is possible to understand whether the ovulation occurs or not by using ovulation predictor kits, blood testing sample, an ultrasound examination and also by looking through the woman’s temperature charts.
To test the ovarian function a physician checks the Day 3 FSH level in blood (measuring follicle stimulating hormone on the third day of period), Day 3 Estradiol, inhibin B and other hormones.
A semen analysis includes the determining of fluid level, the number of sperm, sperm mortality and sperm morphology.
If all results are normal, the additional tests may be needed: hysterosalpingogram, hysteroscopy, laparoscopy or endometrial biopsy.
After the complete examination and determining the reason for infertility, patient or a couple will be advised to undergo the appropriate treatment.
