Fertility Evaluation

The desire to have children is not an unusual one; in fact, over 350,000 babies are born into the world each day. However, having a child of your own could present a unique set of unexpected challenges including many factors that may be causing you trouble in the fertility process like age, lifestyle choices and external influences. If you find that you and your partner have repeatedly attempted to conceive, and in the process have been consistently unsuccessful, infertility of some variety may be the culprit. A fertility evaluation involves physical exams, as well as medical and sexual histories of both partners, in order to isolate the root cause of your fertility woes.

To schedule a consultation with a fertility specialist in that specializes in fertility evaluation and treatment, call (408) 946-9453 or contact us online.

Fertility Testing: What to Expect

If you are having difficulties getting pregnant, your healthcare provider will recommend you undergo fertility testing if:

• You have been having unprotected sex regularly for a year (or 6 months if the female partner is over 35) and are still unsuccessful
• The female partner has had irregular periods, a history of abdominal or pelvic surgery or miscarriage, or a hormonal disorder affecting the ovaries such as polycystic ovary syndrome (PCOS)
• The male partner has a history of having a low sperm count, poor motility (the sperm doesn’t swim or move quickly) or abnormal morphology (the shape of the sperm cells are irregular)

Fertility may be caused by a number of factors. About 40% of couples are infertile due to more than one cause, while the remaining 60% of couples are infertile due to a problem caused by one partner's infertility. Your fertility specialist will begin your initial fertility evaluation and treatment appointment by taking a thorough medical history of each partner. Questions will likely be asked regarding past surgeries, preexisting or chronic illnesses, past hospitalizations as well as whether any previous fertility-related treatments were undergone. Additionally, questions about your lifestyle will be asked, relating to possible stress, weight fluctuations, or the use of tobacco, alcohol, drugs or any current and past medications.

You will also be asked to provide a detailed account of your reproductive history, including any information related to previously attempted pregnancies, miscarriages, elective abortions as well as sexually transmitted diseases (STDs). While some embarrassment regarding these personal questions is only natural, it is important to be forthright with your healthcare provider to ensure all factors are considered.

Fertility Evaluation and Treatment

Once a detailed medical history is covered, your healthcare provider will then complete a fertility workup of both partners, which could consist of many different fertility tests.

Male fertility testing may include:

• A thorough physical exam, including an examination of the external genitals and rectal area to identify structural abnormalities that could be affecting infertility.
• Blood tests to rule out any possible diseases or STDs as well as to determine the level of testosterone and other hormones in the blood.
• Urine tests to rule out health problems such as diabetes and kidney infection.
• A sperm evaluation to inspect your sperm count, motility and morphology.
• A biopsy of the testicles if the semen analysis shows no sperm is present.
• A Doppler ultrasound or venography (an X-ray of the testicular veins) to evaluate blood flow if your healthcare provider suspects you are suffering varicocele (a varicose vein in the testicle), which is a structural problem in men accounting for approximately 40% of male factor infertility cases.

Female fertility testing may include:

• A full, physical exam, including a pelvic examination, screening for STDs (such as chlamydia), blood tests and urine tests.
• An ovulation evaluation, which usually involves one to two months of charting with an ovulation-detection kit (a test which uses daily urine samples to predict ovulation).
• A series of blood tests taken at varying points in the menstrual cycle to evaluate hormones.
• Pelvic ultrasounds to monitor follicle growth and the release of healthy eggs.
• A hysterosalpingogram (an X-ray of the uterus and fallopian tubes after they’ve been injected with dye) to determine whether the tubes are open.
• An endometrial biopsy (an evaluation of the uterine lining) to inspect for hormonal imbalance that can cause irregular cycles, repeated miscarriages or irregular uterine bleeding.
• A laparoscopy to confirm the presence of endometriosis, a disorder in which the endometrial tissue is found outside the uterine cavity.
• A postcoital test (PCT) to examine the quality of your cervical mucus as well as to see how well your partner’s sperm interacts with it. This test allows your healthcare provider to see how well your partner’s sperm can penetrate and survive in your mucus.

After Your Fertility Evaluation

Following both the male and female tests for fertility, your healthcare provider will discuss the results, any infertility issues he or she has observed as well as how to proceed.

Fertility evaluation by a trained fertility specialist can help you navigate the process. To schedule a fertility evaluation in , call (408) 946-9453 or contact us online.

Author

Gul A. Zikria, MD, FACOG As an expert in preventive care, innovative treatment solutions, and laparoscopic surgery, board-certified OB/GYN Gul A. Zikria, MD, FACOG, is a trusted practitioner who’s been in private practice since 1985. Dr. Zikria earned his doctor of medicine from Rutgers New Jersey Medical School in Newark. He went on to complete a competitive surgical residency program at Georgetown University in Washington. Dr. Zikria then went through a comprehensive obstetrics and gynecology residency program through the University of Pittsburgh Medical Center at the Magee-Women’s Hospital. He welcomes new and existing patients to his practice in Milpitas, California.