INFERTILITY: DIAGNOSING THE CAUSE
INFERTILITY: DIAGNOSING THE CAUSE
INFERTILITY: DIAGNOSING THE CAUSE
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Withsomanyfactorsaffecting infertility, finding the exact cause or causes can often be a challenge. To avoid unnecessary testing and treatment, most doctors will not make the diagnosis of infertility until one year of unprotected intercourse has failed to result in pregnancy.
This is because even among fertile couples the chance of conception in any given month is only about 20 percent. In cases involving older couples or where there is evidence of infertility with previous partners, physicians may diagnose infertility sooner so they can try to identify the cause and begin aggressive treatment.
Once physicians diagnose infertility, they use medical histories, physical examinations, and laboratory tests to find its cause.
Medical History
Adoctorwillbeginan evaluation by asking both partners about their medical histories to identify past illnesses, injuries, surgeries, or prescription drug use that may affect fertility. The medical history should also uncover information about past pregnancies or miscarriages, risky behaviors (such as smoking, frequent hot tub use, or the use of harmful drugs), and exposure to hazardous chemicals from jobs or hobbies.
In addition, the doctor may ask about medical problems of other family members to determine if an inherited disorder exists within a family.
Physical Examination
Followingthemedical history, a doctor will give both partners a physical examination of the reproductive system. In men, the doctor will examine the testes, penis, scrotum, and prostate for structural defects or infections.
The doctor will also search for obvious signs of hormonal imbalance, including enlarged breasts or excessive body or facial hair. In women, the doctor will look for structural problems or disease in the vagina, cervix, uterus, and fallopian tubes. Outward signs of hormonal imbalance in women may include the presence of excessive hair, acne, or obesity.
Laboratory Tests
Doctorsuselaboratory tests to uncover factors that cause infertility.
In men, a semen analysis determines the quantity and health of sperm. In women, the primary focus of laboratory tests is to determine if a woman ovulates properly. Since hormones regulate ovulation, a doctor may order a number of blood tests performed over a period of a month to identify levels of sex hormonesestrogen, follicle-stimulating hormone (FSH), and luteinizing hormone (LH)during different stages of the menstrual cycle.
Testing in women may also include an X ray of the fallopian tubes to determine whether the tubes are blocked.
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