A woman should be evaluated for any suspected infertility if she is unable to get pregnant after having 12 months of regular and unprotected sexual intercourse. A health care provider will ask basic questions about women health history for exploring root causes of infertility during evaluating of a woman’s fertility health. These questions may include:
- History of past pregnancies
- History of irregular menstrual cycles
- History of abnormal vaginal bleeding or discharge
- Known or suspected problems with the tubes, uterus or other problems in the abdominal cavity
- Prior miscarriage cases
- If she has abnormal vaginal bleeding or discharge
- If she has a history of previous pelvic surgery or pelvic infection
- Known or suspected male infertility problems
The evaluation should include the male as well as female partners and should be performed in a focused way to find all relevant factors for infertility. The least invasive methods should be tried first. The following tests may be performed as part of the infertility evaluation:
Hysterosalpingogram (HSG): A hysterosalpingogram (HSG) is a procedure that uses an X-ray to see if the fallopian tubes are open and to if the shape of the uterine cavity is normal. This procedure usually takes less than 5 minutes and you can go home the same day. This procedure usually has been performed after period but before the ovulation, since it’s less likely that pregnancy occurred during this time.
Transvaginal Ultrasonography: An ultrasound probe is inserted into the vagina that causes sound waves to bounce off organs inside the pelvis to check the uterus and ovaries for abnormalities such as fibroids and ovarian cysts. These sound waves form echoes that are sent to a computer which produces a picture called a sonogram. This test is also called transvaginal sonography and TVS.
Male Partner Semen Analysis: Semen analysis is an important part of the infertility evaluation, although it is obtained from the male partner. A semen analysis provides information about the shape, movement and number of the sperm. A semen analysis is still important even if the male partner has fathered a child before.
Other Blood Tests: Other blood tests can be useful to check prolactin and thyroid-stimulating hormone (TSH) and to identify thyroid disorders and hyperprolactinemia which may cause problems with fertility, repeated miscarriages and menstrual irregularities. A blood test done around day 23 of the woman’s menstrual cycle can identify the amount of a hormone known as progesterone. This test detects whether ovulation has occurred and whether the ovaries are producing normal amount progesterone.
Laparoscopy: Laparoscopy is a surgical diagnostic procedure in which a lighted telescope-like instrument (called laparoscope) is inserted through the wall of the abdomen into the pelvic cavity used to examine the organs inside the abdomen. Laparoscopy allows your doctor to view and analyze inside your body in real time, without open surgery. Your doctor also can receive biopsy samples during this procedure. Laparoscopy should not be the first option in the evaluation of a female patient, as it involved high potential surgical risk and cost. It may be recommended depending on the woman’s health conditions and the results of other tests. How IVF can be a big life changer?