Infertility occurs when a couple is unable to conceive after 12 months of having intercourse without the use of birth control. The male partner, the female partner, or both partners may have a problem with their fertility. Men and women are equally likely to have fertility problems.
In men, the most common reasons for infertility are sperm disorders such as low sperm count, low sperm motility, malformed sperm, and blocked sperm ducts. The main causes of infertility in women are anovulation, or lack of ovulation, and the inability of the fallopian tubes to carry eggs from the ovary to the uterus.
It is generally recommended that you have an infertility evaluation after you have tried unsuccessfully to become pregnant for 12 months or more. In cases, where the female partner is over 35, it is recommended that you have an infertility evaluation after 6 months of unprotected sex. The infertility evaluation will determine the reasons you have been unable to conceive so that a treatment plan can be developed.
Since men and women are equally likely to have fertility problems, the infertility evaluation includes both partners. The basic infertility workup includes:
A semen analysis is a key part of the basic infertility workup. This analysis may need to be done more than once. The semen sample is obtained by masturbation. Sometimes the semen sample can be obtained at home, other times it is obtained in a lab. Your doctor will give you instructions and make sure you feel as comfortable as possible about the semen analysis.
The semen sample is sent to a lab, where it is analyzed for:
If any potential problems with the urinary tract are found, the male partner most likely will be referred to a urologist for further testing.
For the female partner, the infertility evaluation begins with a physical exam and a comprehensive health history. The health history will focus on four key points:
Another important part of the evaluation is determining whether or not and when you are ovulating. Here are some of the tests that may be performed:
Other tests may be used to examine your reproductive organs. These tests check the appearance of your uterus and determine if your fallopian tubes are open. Your individual circumstances and symptoms determine which of these tests are performed.