WHEN SHOULD A COUPLE SEEK FERTILITY EVALUATION?

Isn’t it sad to know that pregnancy no longer comes easily and in the timeframe we want? Due to the change in lifestyle, eating habits, daily routine and stress, our body has gone for a toss and so is the reproductive system. Infertility has touched more than half of the population therefore making it a very common problem in the present day.

Infertility is not an inconvenience but, a disorder of the reproductive system which disturbs the body’s ability to perform the most basic function of reproduction. It affects both, men and women equally. In about 40 percent of the infertile couples, the male partner is the sole reason or a contributing member for the cause of infertility. Read to know more about fertility evaluation and when a couple should opt for it.

When to seek fertility evaluation?

Approximately 85% of the couples should achieve pregnancy within the first year of unprotected sex. It is reported that about 20-25% of the couples seek some form of fertility evaluation at some point in their lifetime. The diagnosis process is definitely stressful and anxiety provoking. When there is a difficulty getting pregnant, the couple approaches the doctor and the doctor recommends the couple to seek fertility evaluation.
Following are the cases when a doctor recommends fertility evaluation to a couple;

• The couple have been regularly having unprotected intercourse for 6 to 12 months and still have not achieved pregnancy.
• The woman has had irregular and painful menstrual cycle, a history of pelvic surgery, miscarriage or an exposure to any synthetic hormones.
• The man has a history of reduced sperm count, poor sperm motility or an abnormal morphology of the sperm.

When the couple complains of any of these above mentioned points, the doctor recommends the couple to get a fertility evaluation done.

Evaluation Process

The cause for infertility could be one or more than one. Sometimes the reason for infertility cannot be explained. A complete evaluation may require many visits to the doctor to obtain a physical examination of the couple to make a note of the complete medical history.
The doctor may ask for a detailed reproductive history which includes information about miscarriage, abortions, previous pregnancies, current sexual practice, the frequency and duration of intercourse. These questions will find out the root cause of the problem.
Both the partners are then asked to perform a few tests individually. This will help the doctor provide the most appropriate treatment to the couple suffering from infertility.

Infertility testing for men
• A thorough physical examination which includes the examination of the external genitals and area surrounding the rectum to check for any structural abnormalities.
• Blood tests are performed to check the levels of testosterone and other hormones present in blood. Also to rule out a few diseases.
• Urine test to check for the functioning of the kidney and to rule out problems such as diabetes.
• Semen analysis is performed to check the sperm count, sperm motility, the shape and structure.
• A biopsy of the testicles in case the semen analysis shows the absence of sperm.
A Doppler ultrasound or a venography is performed in case the doctor suspects the presence of a varicose vein in the testicle of the man. This is performed to evaluate the flow of blood in the testicles.

Infertility testing for women

A woman’s fertility evaluation is complicated when compared to her partner. To perform the infertility test in a woman, it is necessary for her to be in a certain phase of the menstrual cycle and therefore the tests may take 3 to 4 days to complete.
• A complete physical examination which includes a pelvic examination, blood tests, urine test and screening for STDs.
• An ovulation evaluation
• A number of blood tests at various stages of the menstrual cycle to check the hormone levels.
• Pelvic ultrasound to monitor the growth of the follicle and to check the release of healthy cells.
• An ultrasound to check the progesterone levels.
• A hysterosalpingogram (an x-ray of the uterus and the fallopian tube after the injection of a dye), to check the morphology of the uterus and the openings of the fallopian tubes.
• An evaluation of the uterine lining to check for any imbalance in the hormones which can be the reason for irregular periods and repeated miscarriages.
In some cases, the doctor recommends a laparoscopy to check the internal pelvic area, fallopian tubes and the ovaries for the development of endometriosis disorder (presence of endometrial tissue outside the uterine cavity).

A post-coital test (PCT) is also performed to check the mucus quality of a woman and its interaction with a male sperm.