The fundamental infertility evaluation includes a number of medical tests: transvaginal ultrasound, bloodstream tests, examination of the fallopian tubes (for a female partner) and semen analysis (for a male partner).
Transvaginal ultrasound enables a fertility specialist to evaluate the condition of the uterus and the ovaries. During this infertility evaluation, a fertility specialist may uncover uterine irregularities, for example fibroids (benign abnormal formations of the uterus) or uterine polyps (benign abnormal formations in the lining of the uterus). Ultrasonography may also identify the position of the ovaries and detect the amount of hair follicles present (antral follicle count), which correlates with the woman’s reaction to fertility medications. Additionally, a study of the ovaries may reveal the existence of abnormal ovarian growths, for example endometriomas, dermoid growths or – in rare cases – precancerous and cancerous lesions.
As a part of the infertility evaluation, additionally to the routine vaginal ultrasound, an exam of the fallopian tubes and the uterus cavity is suitable if a woman is getting trouble conceiving. This examination is generally accomplished via a hysterosalpingogram (HSG), an X-ray test that is carried out under fluoroscopy by either the fertility physician or a radiologist. Even though it may sometimes cause mild uterine cramping, most patients tolerate this process quite easily. The options with the hysterosalpingogram include also laparoscopy and hysteroscopy.
Laboratory tests of the female partner of the infertile couple usually include routine screening tests, for example blood type, bloodstream count and rubella immunity. Additionally, most doctors perform tests that aim to detect the woman’s prolactin and thyroid-stimulating hormone (TSH) levels. Additional reproductive hormone testing for ovarian reserve is a part of the routine infertility evaluation, too.
Routine testing of the husband or boyfriend of the infertile couple features a fundamental semen analysis evaluating number of semen, its strength (sperm fertility), proportion of moving sperm (sperm motility) and the number of normally formed sperm (sperm morphology). Even though some fertility treatment centers perform additional sperm function tests, like the acrosome reaction and hypo-osmotic swelling test, the general benefit of those tests remains somewhat questionable. These two tests make an effort to predict the moving ability of the sperm when it comes to the ability to fertilize an egg.
Ultimately, the very best proof of a normal sperm function is really a recent pregnancy or normal fertilization within a cycle of In vitro fertilization (IVF) treatments.
Infertility evaluation that identifies the existence of antisperm antibodies in the bloodstream of the female partner may be suggested. Female antisperm antibodies could cause infertility that is best cured by IVF treatments. The antisperm antibodies that are present around the sperm may hinder normal fertilization. In such cases, collecting a semen sample for an artificial insemination might be considered, but many of such patients pursue IVF treatments with Intracytoplasmic sperm injection (ICSI).