Diagnosing Infertility
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Infertility tests assess the processes that must occur for pregnancy to result.
First, the male must produce sufficient sperm that are capable of fertilizing an egg. These sperm must be ejaculated and travel to the fallopian tube, the site of fertilization. The semen analysis examines the quantity and quality of sperm. Some degree of male factor infertility is present in 40% of infertile couples.
The female must produce eggs that will fertilize and they must be ovulated during her monthly cycles. Various tests, such as progesterone hormone measurements, assess whether or not ovulation is occurring.
The eggs must travel through the fallopian tubes to the uterus. Tests such as the hysterosalpingogram determine if the tubes are open and free of obstruction.
The uterus must be normally shaped and free of fibroids, polyps or deformities. The hysteroscopy and hysterosonogram allow the physician to view the inside of the uterus.
The laparoscopy is performed to view and evaluate the reproductive organs. Many times conditions, such as endometriosis, can be treated during the diagnostic laparoscopy.
A woman’s fertility declines with age due to decreasing egg quality and numbers. Tests such as blood levels of anti-mullerian hormone (AMH), or follicle stimulating hormone (FSH) and estradiol on cycle day 3 help determine the fertility potential or response to medical treatment. Other tests that can be used are antral follicle count (ACF) by ultrasound or clomiphene citrate challenge test (CCCT).