What goes into a fertility evaluation ?

Infertility is a serious worry for many couples. It’s a diagnosis that can dramatically alter the life that you always imagined for yourself. If you’re trying to get pregnant and are having difficulty, you know just how much of an emotional roller coaster it can be. For most, achieving pregnancy causes no problems, but some couples do experience difficulties. More than 80% of couples where the woman is under 40 will conceive naturally within one year of having regular unprotected sex.

A standard fertility evaluation includes physical exams and medical and sexual histories of both partners. Men undergo a semen analysis that evaluates sperm count, movement and structure.

For women, doctors first check to see whether ovulation is occurring or not through blood tests, ultrasound, or an ovulation home kit. An irregular menstrual pattern would be suspicious of an ovulation problem, but it's also possible with regular periods.

Other Tests

• BBT charting  Basal body temperature is a way of checking ovulation. It is a technique that has been used for ages, but is not as accurate as other ovulation tests.
• Post-coital test  This test requires that you have intercourse several hours in advance and then visit your doctor to have a sample of cervical mucus taken for microscopic examination. It's a way of testing both the viability of the sperm and their interaction with the cervical mucus.
• Transvaginal Ultrasound is done to check the condition of the uterus and ovaries. Hysterosonography and SonoHSG are more technical ultrasounds that involve putting saline and or bubbles into the uterus during an ultrasound to evaluate uterine cavity and fallopian tubes.
• Hysterosalpinogram  HSG or "tubogram." In this , a series of X-rays is taken a dye has been injected into your uterus through cervix and vagina. It helps to diagnose fallopian tube blockages and defects of the uterus.
• Hysteroscopy If a problem is found in the HSG or ultrasound one may need a hysteroscopy. In this procedure, a thin telescope-like instrument is inserted through the cervix into the uterus to allow the doctor to see for problems and treat at the same time.
• Laparoscopy It allows doctors to examine the ovaries, uterus, fallopian tubes, and abdominal cavity. This involves inserting a fiber-optic telescope into the abdomen. One advantage of laparoscopy is that it allows doctors to both diagnose and treat conditions such as endometriosis, adhesions, tubal blockages, fibroids etc at the same time.
• Endometrial biopsy  A biopsy of uterine lining may be done to see if it's normal, so an embryo could implant in it.

It's time to check with a doctor if you've had regular sex without birth control for 6 to 12 months. It is important for the couple to go for consultation together. In many cases, infertility is the result of a combination of problems, sometimes in each partner.

Trying to conceive can be an emotional process, so it's important to support each other as much as possible.