Testing and Diagnosis
Infertility is a disease that, according to The Center for Disease Control and Prevention, affects more than 7.3 million Americans, or 1 in 8 couples of childbearing age.
Reproductive endocrinologists (doctors specializing in infertility) generally consider a couple infertile and eligible for treatment under
the following conditions:
If the woman is under 35 and has not conceived after 12 months of
contraceptive-free intercourse.
If the woman is over 35 and has not conceived after 6 months of
contraceptive-free sexual intercourse. The reason for the shorter time-frame
for women over 35, is that is more of a sense of urgency due to declining
fertility. Every month counts and it is not wise wait another 6 months to
prove the necessity of medical intervention.
If you are looking for a reproductive endocrinologist, see the IHR.com directory of fertility clinics to find
one in your area.
Normally, a complete medical history and a physical exam are the first steps
in diagnosing a fertility problem. After that, some of the diagnostic tests for
infertility might include:
blood tests and urine tests to check hormone levels
Further, more complex tests include one of the following:
Laparoscopy:
If the doctor suspects ovarian or fallopian tube scarring or endometriosis,
a woman may undergo a laparoscopy. The doctor makes two small incisions at the
pubic bone and navel, and carbon dioxide gas is injected into the stomach to
enlarge it.
Then the doctor inserts a laparoscope, a long tube with lenses and a
fiber optic light, into one incision and a long probe through the other opening
in the skin. With the probe, the doctor can view the ovaries, fallopian tubes
and uterus to check for scar tissue. In some cases, he may cut away scar
tissue discovered during this operation.
The woman usually has to undergo general anesthesia for the procedure, but
the risks of bleeding, infection and reaction to the anesthesia are slight.
Hysterosalpingogram:
This test checks the condition of the woman's fallopian tubes.
The doctor clamps the cervix and injects a needle filled with dye into the
woman's uterus. An X-ray is taken to determine whether the dye passes through
the open ends of the fallopian tubes. If the dye emerges from the end of the
tubes, they are not blocked.
The test may also reveal other fertility problems, such as fibroid tumors,
structural abnormalities and endometrial polyps. In some cases, the dye
actually clears away blockages in the fallopian tubes, and restores the
woman's fertility.
The dye is harmless and is absorbed by the woman's body after going through
her tubes. The test may be uncomfortable, but is rarely painful.
Unfortunately, it is noted for both false positive and false negative
diagnoses.
(Reference: http://www.ihr.com/infertility/diagnose.html)
Infertility is a disease that, according to The Center for Disease Control and Prevention, affects more than 7.3 million Americans, or 1 in 8 couples of childbearing age.
Reproductive endocrinologists (doctors specializing in infertility) generally consider a couple infertile and eligible for treatment under
the following conditions:
If the woman is under 35 and has not conceived after 12 months of
contraceptive-free intercourse.
If the woman is over 35 and has not conceived after 6 months of
contraceptive-free sexual intercourse. The reason for the shorter time-frame
for women over 35, is that is more of a sense of urgency due to declining
fertility. Every month counts and it is not wise wait another 6 months to
prove the necessity of medical intervention.
If you are looking for a reproductive endocrinologist, see the IHR.com directory of fertility clinics to find
one in your area.
Normally, a complete medical history and a physical exam are the first steps
in diagnosing a fertility problem. After that, some of the diagnostic tests for
infertility might include:
blood tests and urine tests to check hormone levels
- urine tests to evaluate LH surges
- an endometrial biopsy, in which the doctor removes a piece of tissue in
the uterine lining. Examining this tissue will tell the physician whether eggs
have been released and whether the corpeus luteum is producing enough
progesterone. This test is often done if the results from the woman's basal
body temperature chart are unclear. - an ultrasound to look for fibroids and cysts in the uterus and ovaries.
This test uses sound waves to picture the uterus and ovaries, causes little
discomfort, and is very effective. - a post-coital test, in which the doctor takes a sample of mucous from the
woman's vagina. She must have the test during her fertile days and within 12
hours after she and her partner have sex. The test will tell the doctor if the
man's sperm can survive in the woman's cervical mucous.
a Pap smear to check the health of the cervix
a basal body temperature test, which checks whether the woman is releasing
eggs from her ovaries. A woman's temperature rises slightly during the days
she ovulates. The woman will chart her basal body temperature every day for a
few months on a graph. She will take her temperature orally or may take her
temperature vaginally with a special ultra-sensitive thermometer available at
most drugstores.
Further, more complex tests include one of the following:
Laparoscopy:
If the doctor suspects ovarian or fallopian tube scarring or endometriosis,
a woman may undergo a laparoscopy. The doctor makes two small incisions at the
pubic bone and navel, and carbon dioxide gas is injected into the stomach to
enlarge it.
Then the doctor inserts a laparoscope, a long tube with lenses and a
fiber optic light, into one incision and a long probe through the other opening
in the skin. With the probe, the doctor can view the ovaries, fallopian tubes
and uterus to check for scar tissue. In some cases, he may cut away scar
tissue discovered during this operation.
The woman usually has to undergo general anesthesia for the procedure, but
the risks of bleeding, infection and reaction to the anesthesia are slight.
Hysterosalpingogram:
This test checks the condition of the woman's fallopian tubes.
The doctor clamps the cervix and injects a needle filled with dye into the
woman's uterus. An X-ray is taken to determine whether the dye passes through
the open ends of the fallopian tubes. If the dye emerges from the end of the
tubes, they are not blocked.
The test may also reveal other fertility problems, such as fibroid tumors,
structural abnormalities and endometrial polyps. In some cases, the dye
actually clears away blockages in the fallopian tubes, and restores the
woman's fertility.
The dye is harmless and is absorbed by the woman's body after going through
her tubes. The test may be uncomfortable, but is rarely painful.
Unfortunately, it is noted for both false positive and false negative
diagnoses.
(Reference: http://www.ihr.com/infertility/diagnose.html)