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Fertility Assessment For Couples
Couples should consult the Fertility Expert when unable to achieve pregnancy after one year of marriage at less than 35 years of age and after 6 months in more than 35 years of age of wife.
Female fertility testing – For a female to be fertile, the ovaries must release healthy eggs regularly, and her reproductive tract must allow the eggs and sperm to pass into her fallopian tubes to become fertilized by sperm. Fertility assessment of females includes –
- History – Past medical history, menstrual history, sexual history, previous fertility evaluation or treatment
- Physical Examination – General physical examination like excess facial hair, pelvic examination to check for ovarian masses, uterine pathologies – like fibroid etc.
- Hormonal tests
- AMH, FSH, LH, Serum Estradiol – Hormonal tests to check the egg reserve of ovaries
- Thyroid profile, Prolactin – Hormonal tests important for menstrual regularity and implantation of embryo
- Pelvic ultrasound – Helps to check status of ovaries, uterus and identifies the pathology
- Hysterosalpingography/Sonosalpingography – Evaluates the patency of fallopian tubes and any uterine pathology. Blockage or problems often can be located and may be corrected with surgery.
- Endoscopic procedures (Laparoscopy and Hysteroscopy) – Minimal invasive procedures are performed to know exact condition of ovaries, fallopian tubes, uterus and surrounding structures and in same sitting operative procedures can be done.
- Endometrial Biopsy – Uterine tissue is taken to rule out tuberculosis of genital tract
Male Fertility Tests –
For a male to be fertile, the testis must produce enough healthy sperm and the sperm must be ejaculated effectively into the woman’s vagina. Fertility assessment of males includes –
- History – Past medical history, sexual history, occupational history
- General physical examination – Examination of genitals should ideally be performed by a urologist
- Semen analysis – Most important test for the male partner to check sperm count, sperm motility, pH, sperm morphology, volume, fructose content, and acrosome activity.
- Hormone testing – FSH, Total testosterone, Thyroid profile, Prolactin to check for sperm production
- Transrectal and scrotal ultrasound – Ultrasound to determine the evidence of conditions such as retrograde ejaculation and ejaculatory duct obstruction.
Though infertility is common in today’s world, it is preventable and treatable by a fertility expert at an early age.