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An infertility evaluation is recommended if you have not become pregnant after 1 year of regular sexual intercourse without using any form of contraception.
An infertility evaluation is recommended if you have not become pregnant after 1 year of regular sexual intercourse without using any form of contraception. If you are older than 35 years, an infertility evaluation may be performed after 6 months of trying to conceive.
During an infertility evaluation, both you and your partner may undergo tests to try to find the cause. The first visit usually involves a detailed medical history and physical exam. You will be asked questions about your periods, medications you are taking, medical problems and past surgeries, illnesses or birth defects in your families, past pregnancies and miscarriages, tobacco and drug use.
There are many causes of infertility and many treatments that can help couples get pregnant. Male factor infertility may be the only cause of infertility in about 10% of couples and female factors occur in about 35% of couples. Often, infertility occurs due to both female and male factors in another 35% of couples. Reasons for female factor infertility include ovulation difficulties or anatomic issues. Sometimes a cause of infertility is not found, this is called unexplained infertility. Up to 15-30% of couples who undergo an infertility evaluation do not find a reason for their difficulty getting pregnant. There are many treatments for the different causes of infertility.
An assessment of whether you ovulate is done, usually by evaluating your menstrual cycle, basal body temperature assessment, ovulation predictor kits or progesterone levels. Various blood tests may be performed to assess thyroid disease, prolactin levels and ovarian reserve (the function of the eggs found in the ovaries), which can all disrupt ovulation. Tests of ovarian reserve must be done on the third day of your period. In addition, a hysterosalpingogram (special x-ray of the uterus) may be performed to assess the inside of your uterus and look at whether the fallopian tubes are blocked. Your doctor will discuss which tests you should have.
The appropriate treatment for infertility depends on the cause. If a cause is not found, there are still many treatments. Often, your doctor may start with a medication that stimulates ovulation, called ovulation induction. Depending on your situation, your doctor may refer you to a reproductive endocrinologist or infertility specialist.