How is Infertility Diagnosed?
It is generally recommended that couples that have been trying to get pregnant for a year and still are not should seek medical assistance. The physician will perform a complete physical exam on both partners in order to determine how healthy each person is and to evaluate whether a physical problem is to blame for the
infertility or not. Sometimes a doctor will interview both people to talk about their sexual habits in order to find out if the couple is using the proper positions during intercourse to facilitate conception.
If the physician reaches this point and has not yet determined the cause for the infertility then diagnostic tests will need to be run on both partners to learn more. Besides the medical history and physical exam, the man may need to undergo blood tests that look for a variety of diseases or hormonal imbalances. If those yield nothing out of the ordinary then a semen sample will need to be taken. The sample will assess the volume of semen the man has as well as the number of sperm and how mobile the sperm are.
The physical for a man can be uncomfortable but it is essential in order to look for any signs that a problem exists such as decreased body hair for example. The contents of the scrotum will need to be palpated while the patient is standing up while the peritesticular area need also be scrutinized. Some things a doctor will look for are irregularities of the epididymis, tenderness or the presence of cysts.
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The two most common reasons for male infertility are azoospermia (which is a condition where there are no sperm cells produced at all) and oligospermia (which is when there are only a minimum of sperm cells produced). In some instances, sperm cells do not form properly or else they die before they are able to reach an egg and fertilize it. There are rare cases where a genetic disease such as cystic fibrosis or a chromosomal abnormality is to blame for male infertility.
For a woman, the search for infertility must also begin with a look at medical history as well as a complete physical. Very often other kinds of medical tests are also needed such as an endometrial biopsy which tests the health of the uterine lining, hormone tests which measure the balance of female hormones, measurements of how well the thyroid is functioning (a TSH or thyroid stimulating hormone level that lies somewhere between one and two is believed to be right for pregnancy to take place) and a laparoscopy which makes it possible for the physician to see all of the pelvic organs.
A measurement of the hormone progesterone is sometimes taken when a woman is in the second half of her menstrual cycle in order to confirm that ovulation has definitely taken place. A pap smear to look for any signs that there may be an infection or cysts is a necessary diagnostic test for infertility problems. Accompanying a pap smear is usually a pelvic exam that seeks to root out an infection or any kind of abnormalities. Sometimes there are special kinds of X-ray tests that are done to illuminate further the cause of infertility. Postcoital tests done directly after sex were once common to check for the presence of normal secretions due to intercourse however these tests are not often done anymore because they have been proven to yield unreliable results.
A diagnosis of infertility should always be made by a doctor who is fellowship trained as a "reproductive endocrinologist." Those professionals deemed as reproductive endocrinologists are most often obstetrician-gynecologists who have advanced training in the field of "Reproductive Endocrinology and Infertility" in North America.
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