An infertility evaluation is performed to determine the source of a couples inability to become pregnant. Such an evaluation is typically performed when a couple has been having difficulty conceiving a child for an extended period of time, usually a year, even though they regularly engage in unprotected sexual intercourse. Diagnostic tests are used to detect any conditions or abnormalities that may interfere with the ability of one or both partners to conceive offspring.
Infertility does not mean that a couple is sterile and will never have a child. Approximately half of all couples who seek help for infertility will eventually conceive.
Candidates for Infertility Evaluation
Candidates for infertility evaluation include couples who have spent at least a year trying to conceive, couples in which the woman is older than age 35 who have spent at least 6 months trying to conceive, and couples in which one or both partners are known to have problems affecting fertility. Women may also be tested for infertility if they:
- Menstruate irregularly or not at all
- Are older than 40 years of age
- Have had more than one miscarriage
- Have a condition known to interfere with fertility
Men may also be tested for infertility if they:
- Are known to have a low sperm count
- Have a swelling in the scrotum
- Have had a vasectomy
- Have undergone scrotal or inguinal surgery
- Have abnormally small testicles
- Have diminished libido or erectile dysfunction
Either partner may want to be tested if they have undergone cancer treatments. At times, one or both partners may opt to have fertility testing just because they are curious, or worried, about their fertility status.
The Infertility Evaluation
During the initial infertility evaluation, both the female and male partner undergo a full physical examination. Their complete medical histories are reviewed and their urine and blood are tested.
Tests for Female Infertility
Tests for female infertility may include:
- Testing of reproductive hormone levels
- Ovulation testing
- Imaging tests of reproductive organs.
Tests for Male Infertility
Diagnostic tests for male infertility may include one or more of the following:
- Semen analysis
- Testing of testosterone levels
- Transrectal and scrotal ultrasound
- Testicular biopsy
- Pelvic ultrasound
Both partners may also be tested for any genetic defects possibly causing infertility. Once the cause of infertility is identified, an individualized treatment plan is designed to maximize the couple's fertility potential and allow for successful conception.