Fertility Evaluation

A fertility evaluation is an essential initial assessment for couples who are having difficulty conceiving, designed to assess the fertility potential of both men and women. The purpose of this evaluation is to identify any underlying issues that may be affecting the couple’s ability to conceive naturally and to guide potential treatment options.

What Does a Fertility Evaluation Involve?

A standard fertility evaluation is a comprehensive process that includes several key components:

Medical and Sexual Histories

• For both partners, the evaluation begins with a detailed review of medical and sexual histories. This includes questions about past illnesses, surgeries, current medications, lifestyle factors, sexual activity, and any previous pregnancies. These details help identify factors that might be influencing fertility, such as past infections, sexually transmitted infections (STIs), hormonal imbalances, or lifestyle habits like smoking and alcohol consumption.

Physical Examinations

• Men and women undergo a physical exam as part of the fertility evaluation. This allows doctors to assess general health, reproductive anatomy, and identify any obvious physical abnormalities that could affect fertility, such as varicoceles in men or signs of polycystic ovary syndrome (PCOS) in women.

Fertility Tests for Men

The focus of male fertility evaluation is typically on the semen analysis, which assesses various factors related to sperm health, including:

• Sperm Count: Measures the number of sperm in a sample.
• Sperm Motility: Evaluates how well the sperm move or swim toward the egg.
• Sperm Morphology: Assesses the size and shape of sperm, which can influence their ability to fertilize an egg.

Additionally, men may undergo hormonal tests to check testosterone and other hormone levels, and in some cases, genetic testing or testicular biopsy may be recommended if further investigation is required.

Fertility Tests for Women

• Ovulation Assessment: One of the first steps in evaluating female fertility is determining whether ovulation is occurring regularly. This can be done through:

  • Blood Tests: These measure hormone levels (such as luteinizing hormone (LH), follicle-stimulating hormone (FSH), progesterone, and estradiol) that are crucial for ovulation and reproductive health.
  • Ultrasound Examination: Pelvic ultrasounds are used to visualize the ovaries and check for the presence of developing follicles, confirming whether ovulation is happening.

• Uterine and Fallopian Tube Assessment: Doctors may also assess the health of the uterus and fallopian tubes through:

  • Hysterosalpingogram (HSG): An X-ray procedure used to check for blockages or abnormalities in the fallopian tubes and the shape of the uterus.
  • Transvaginal Ultrasound: This can detect uterine fibroids, polyps, or other abnormalities that might interfere with pregnancy.

• Ovarian Reserve Testing: To assess a woman’s egg supply, doctors may measure anti-Müllerian hormone (AMH) levels and perform antral follicle count via ultrasound, giving an indication of how many eggs remain in the ovaries.