Men will get a physical exam and often a sperm analysis, which tests the health of his sperm.
For women, testing begins with a medical history and physical exam, including a pelvic exam. The doctor then makes sure that she ovulates regularly and her ovaries are releasing the eggs. Blood tests are taken to measure hormone levels. The ovaries and uterus may be examined by ultrasound, and a specific X-ray test can check the uterus and fallopian tubes.
Infertility facts
*Infertility facts medically edited by Charles Patrick Davis, MD, PhD
- Infertility means not being able to become pregnant, within certain parameters.
- Infertility is a common problem of about 10% of women aged 15 to 44.
- Infertility can be due to the woman (33%), the man (33%) and by both sexes or due to unknown problems (33%), approximately.
- Infertility in men can be due to varicocele, low or absent sperm count, sperm damage or certain diseases.
- Risk factors for men's infertility include alcohol and drug use, toxins, smoking, age, health problems, medicines, radiation, and chemotherapy.
- Risk factors for women's infertility include ovulation problems, blocked Fallopian tubes, uterine problems, uterine fibroids, age, stress, poor diet, athletic training, and those risk factors listed for men.
- Aging decreases a woman's fertility; after age 35 about 33% of couples have fertility problems; older women's eggs are reduced in number, not as healthy and less likely to be released by the ovary – the woman is also more likely to have a miscarriage and other health problems.
- Women under 35 should try for a year or 6 months if 35 or older to become pregnant before contacting their doctor if they have no health problems.
- Doctors use the histories of both partners and may run tests such as sperm studies, ovulation tests, ultrasound, hysterosalpingography, or laparoscopy.
- Infertility may be treated with medicine, surgery, artificial insemination, or assisted reproductive technology, based on the couples test results and other factors.
- There are multiple medicines that may be used to treat infertility in women.
- Intrauterine insemination is artificial insemination where a woman is injected with sperm into the uterus.
- ART (assisted reproductive technology) is when a woman's eggs are removed, mixed with sperm to make embryos that are placed back in the woman's body; it's successful about 11% to 39%, depending on the woman's age.
- There are several types of ART; in vitro fertilization, Zygote transfer, Gamete transfer, and intracytoplasmic sperm injection.
- Surrogacy (the woman's male partner sperm is used to fertilize another woman egg and that other woman carries the fetus to term and the infant is then adopted ) is a way for some couples to obtain a baby.
- A gestational carrier is a woman who has an embryo placed in her uterus, carries the fetus to term and gives the baby to the couple (or responsible persons) that produced the embryo.
In about 80% of couples, the cause of infertility is either an ovulation problem, blockage of the fallopian tubes, or a sperm problem. In 5%-15% of couples, all tests are normal, and the cause is not known.
Causes of Infertility
A problem in any one of a number of key processes can result in infertility. Male and female factors can exist in isolation or combination and fertility investigations, diagnoses and treatment should always be considered in the context of the couple.
Male factor
Sperm problems will contribute to about 40% of infertility cases. The normal working of the male reproductive system involves first the production of sufficient numbers of functional sperm cells and then the delivery of these sperm to the ejaculate. Key to the diagnosis of male infertility is a semen analysis, which assesses primarily sperm numbers, sperm movement and sperm form.
Female factor
Dysfunction of the female reproductive organs is also apparent in around 40% of infertile couples. The most common identifiable causes of female fertility problems are outlined below:
• Ovulatory dysfunction, (or anovulation) where an egg is not released from the ovary every month, is the single most common cause of female infertility. Predominantly anovulation is caused by hormonal imbalances such as Polycystic Ovarian Syndrome (PCOS) but ovarian scarring and premature menopause can also result in failure to ovulate.
• Tubal disease, comprising anything from mild adhesions to complete blockage of the fallopian tubes, prevents fertilised eggs from travelling from the site of fertilisation to the uterus. It may also prevent the sperm from reaching the egg. Normal uterine implantation can therefore not occur. The main causes of tubal infertility are pelvic infections caused by bacteria such as chlamydia, previous abdominal disease or surgery and ectopic pregnancy.
• Endometriosis is characterised by excessive growth of the lining of the uterus. These endometrial cells can extend as far as the outside of the fallopian tubes, the ovaries and the bladder. As they respond to hormones the same way as they would do in the uterus, that is by growing and shedding cyclically, endometriosis can cause both fallopian tube and ovarian scarring.
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