Infertility evaluation of female partner

When should fertility testing be done ?

• Not being able to conceive in first year or if female partner is >35 years of age, then earlier.

Conditions that affect female fertility :

PCOS( Polycystic Ovarian Syndrome) : It is one of the most common causes of female infertility in today’s world. Hormonal imbalance leads to increased male hormones in female body which results in problems with ovulation. This is generally accompanied by obesity, acne, facial hair growth and insulin resistance.

1. Premature ovarian insufficiency or Ovarian failure : It may result from a genetic condition, excessive smoking, chemotherapy ,history of ovarian surgery,autoimmune conditions leading to premature depletion of egg number.
2. Tubal factor: Any condition like pelvic infections,abdominal/pelvic tuberculosis,H/O ectopic pregnancy, H/O pelvic surgery may cause damage to the fallopian tubes which prevent sperms from reaching the eggs and hence causing inability to conceive.
3. Endometriosis: In this disorder, the endometrial lining(lining of uterus) grows on the surrounding structures and organs like ovaries,tubes and behind the uterus causing development of cysts in the ovaries and scarring. It is associated with severe pain during menses.
4. Fibroids and Polyps: These can obstruct the reproductive tract and disrupt the implantation of fertilized egg.

Evaluation

Evaluation usually begins with a few questions about your general health, medications,etc.

1. Did you ever get pregnant ? If yes, what was the outcome?
2. How is your menstrual cycle? Regular/Irregular.
3. Are you on any medicines for chronic health problem?
4. Have you undergone any abdominal or pelvic surgery?
5. Are you addicted to smoking,alcohol or drugs?
6. Questions about sexual health and sex life –
   • Frequency of contacts
   • Birth control measures used previously
   • Any problem during or after sexual contact

Tests -What are the tests for female partner ?

• Ultrasound – It is generally a pelvic ultrasound to detect problems in the uterus,ovarian cysts, number of antral follicles,etc.
• Blood tests- These are mainly hormones like thyroid,prolactin levels.Certain hormonal tests to look at the ovarian reserve-like AMH,FSH,LH,E2 which would be done at various stages of menstrual cycles. The ovarian reserve tests help us to find the quantity /number of eggs present in ovaries.
• Hysterosalpingogram(HSG) – It is an X-ray examination after injecting a dye inside the uterus to examine the shape of uterus and patency of fallopian tubes.