Diagnosis & Testing
Sometimes it is hard to know where to start! Rest assured that by choosing Southeastern Fertility you have picked the right place. Dr. Keenan and Dr. Gordon have over 50 years of combined experience in treating the infertile couple.
Whether it is a history of irregular periods or a known diagnosis of endometriosis we will be there to guide you through appropriate diagnostic testing leading to a treatment plan that makes sense for you. The staff of Southeastern Fertility are here to help and support you through the process.
How common is infertility?
After 1 year of having unprotected sex, 15% of couples are unable to conceive—that is, to get pregnant. After 2 years, 10% of couples still have not had a successful pregnancy.
What are the causes of female infertility?
For about a third of couples who have difficulty conceiving, the woman is found to have the problem. In order for a woman to conceive, she needs to ovulate (produce and release eggs from her ovaries), have patent Fallopian tubes (that is, tubes free of blockages), and have a healthy uterus that can support a pregnancy. Fertility can be affected by problems with the menstrual cycle, by a disease or a condition, by lifestyle factors, and/or by age-related factors.
How is female infertility evaluated?
In addition to a health history and physical exam, we routinely order blood tests to check for conditions that may impact your fertility. Common blood tests include:
• TSH to evaluate for thyroid disorders
• Prolactin to rule out inappropriate production of the hormone responsible for supporting lactation
• Anti-Müllerian hormone (AMH) level to evaluate ovarian reserve (your remaining egg supply).
• Follicle-stimulating hormone and estradiol levels in the first few days of the menstrual cycle to evaluate ovarian function.
• Progesterone level late in the second half of your menstrual cycle to tell if ovulation has occurred and if your ovaries are producing a normal amount of this hormone.
Because some of these tests must be done at specific times in the menstrual cycle and repeated for accuracy, this part of your evaluation may take several weeks.
Other tests may be done to examine your Fallopian tubes and determine if a blockage is preventing movement of the egg from the ovaries or preventing the egg and sperm from reaching each other. The options to test the tubes include a hysterosalpingogram (x-ray test of the Fallopian tubes and uterus), FemVue transvaginal ultrasound (TVUS), and laparoscopy. TVUS can also be used to assess your ovaries, including the number of remaining follicles you have, and it can be used to assess the uterus.
What are the causes of male infertility?
For more than a third of couples who have difficulty conceiving, the man is found to have the problem. In order for conception to occur, a man must have sperm that can reach and combine with a woman’s egg. Sperm are made and stored in the testicles. During sex, sperm mix with seminal fluid, or semen, and are ejaculated by the penis into the woman’s reproductive tract. Infertility in a man is often related to low sperm production, which may be due to a varicocele, an enlarged vein in the testicle. Other causes of male infertility are hormone imbalances, medication or steroid use, and blockages in the reproductive organs.
How is male infertility evaluated?
A health history and physical exam are also part of the man’s evaluation. The most common lab test for male infertility is a semen analysis to assess the quantity and quality of the sperm. A man may need to provide a semen sample on more than one occasion because sperm production can vary over time, depending on his activities and stress level.
How is male infertility treated?
Medication can treat problems such as hormone imbalances. Surgery can help repair blockages in the tubes that transport sperm from the testicles to the penis. Surgery can be used to repair a varicocele. If medication or surgery does not restore fertility, IVF may be considered.
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