Probably the easiest part of the evaluation is the testing of the male. In most cases by obtaining a semen analysis we are able to determine whether the male has a significant problem or not.
Evaluation of the female is somewhat more involved than the male. Almost all of your tests have to be done at a certain time in your cycle. Remember, cycle day number one is the day you begin your menses. Your evaluation will involve the following:
- A complete physical examination to include a pelvic examination and pap smear.
- Routine laboratory tests to include your hemoglobin, blood chemistries, and tests to evaluate your thyroid gland.
- OVULATION: We need to assess whether you are ovulating or not. In most females, when conditions are ideal, an egg is released from your ovary at mid-cycle. This process is called ovulation. Usually, ovulation occurs around day 14 of your cycle, with the egg being capable of fertilization only for approximately 24 hours after that. After ovulation, a hormone called progesterone is formed by your ovaries. Your blood levels of progesterone peak around days 20-22, which is when we will be measuring it.
- HSG: PCT:
The cervix is the entrance into the uterus. Once sperm is in the vagina, it must swim through the mucus produced by your cervix to get into the uterus and tubes. Some women do not make enough mucus and other women have mucus that actually kills their husband’s sperm. To test for this, we will be performing a post-coital test (PCT).
- SURGERY: For some women, all the above tests will be done but yet nothing will be found as a cause of her infertility. At that time, we will discuss the possibility of performing a diagnostic laparoscopy. This is a minor surgical procedure that involves placing a telescope through your navel to look at your pelvic organs. Causes for infertility that we may find at the time include endometriosis and adhesions (scar tissue).