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There are many reasons why a couple may have difficulty getting pregnant. Because of careers and later marriages, more women now choose to conceive later in life, after fertility has naturally declined. New methods of birth control have affected fertility. But individual medical problems in both female and male are still the leading cause of fertility problems. In only a few couples does infertility remain unexplained.
Causes of infertility may be associated with the man, the woman or both. Frequently more than one problem may be present in each partner. The graph below depicts the breakdown of diagnosis according to the 2005 Preliminary National Summary by Centers for Disease Control and Prevention:
Since the causes of infertility include lack of sperm availability, lack of egg availability, and failure of the sperm and egg to meet at the proper time, both the husband and the wife must cooperate in the investigation. In the male evaluation, the man will be asked to provide a semen sample to the laboratory. The sample will be analyzed to determine the number of sperm present, the sperm’s motility, sperm shape and other factors.
Several tests are used to diagnose infertility in the woman. Women over the age of 35 should approach the diagnostic process with a sense of urgency. An endometrial biopsy – which measures hormone reactions in the uterus - may be used for this purpose. A tubal patency test is used to determine if the fallopian tubes are open. An x-ray dye test (hysterosalpingogram) provides documentation of the uterine anatomy and the status of the fallopian tubes.
A postcoital test is a very useful examination. It permits evaluation of the mucus following intercourse. Mucus quality and sperm survival are checked at this time using our microscope.
Hormonal imbalances are frequent causes of female infertility. We can determine this by measuring specific female hormone blood levels. Success rates are high for this condition if therapy is individualized and precise.
Laparoscopy is an outpatient surgical procedure used to visually study the interior of the woman’s pelvis and reproductive organs. Conditions such as pelvic adhesions, endometriosis, fibroids and fallopian tube defects can be diagnosed as well as treated simultaneously.
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