Introduction
Infertility is the inability to achieve pregnancy after one year of unprotected intercourse. You should consider seeing a doctor if you have been trying to conceive for a year or more. However, if you are 35 years or older, you should consider starting the infertility evaluation after about six months of unprotected intercourse rather than a year, so as not to delay potentially needed treatment. Also, if you have a reason to suspect an underlying problem, you should seek care earlier. For instance, if you have very irregular menstrual cycles (suggesting that you are not ovulating or releasing an egg), or if you or your partner have a known fertility problem, you probably should not wait an entire year before seeking treatment.
If you and your partner have been unable to have a baby, you’re not alone. At least one out of seven couples has trouble conceiving. During this time, it is normal to experience feelings of frustration, jealousy, anger and stress. However, once you begin to explore your medical options, you’ll find that fertility treatments offer hope for a successful pregnancy.
The Initial Visit
Both you and your partner should try to attend the first meeting since infertility is a shared experience and is best dealt with as a couple. During this visit, you’ll begin to understand the degree of commitment and cooperation that an infertility investigation and treatment requires. It is important that you communicate freely between each other as well as with your doctor.
Your doctor will review your history and ask you and your partner questions to help identify potential causes for your difficulty in conceiving. He or she will ask about the frequency and regularity of your menstrual period, pelvic pain, abnormal vaginal bleeding or discharge, history of pelvic infection, and medical illnesses. Expect questions concerning prior pregnancies, miscarriages, operations, and methods of contraception. Your partner will be asked questions concerning prior genital injury, surgery, infections, drug and/or medication use, history of fathering other children, and medical illnesses. You’ll be asked how long you’ve been trying to conceive, how often you have sexual intercourse, and if anyone in either family has birth defects. Your doctor will need to know the complete reproductive histories of you and your partner, including any former relationships. Since at least 25% of infertile couples have more than one factor causing infertility, so it is very important to evaluate all factors that may affect both you and your partner.
Investigation
A physical examination of you and your partner may follow the initial review. The occurrence and extent of the examinations will depend upon whether or not any factors impacting your fertility are found early in the evaluation. Then, you and your partner might undergo a series of tests. Sometimes this may require a significant amount of time and energy on your part, but the results are important. These tests may include:
- Hormone blood tests: Testosterone in the male and Estrogen, Progesterone and FSH in the female partner. Other hormones possibly of influence include Thyroid hormone and Prolactine
- A sperm test (semen analysis) of the male partner
- Blood test for both partners to screen for sexually transmitted diseases and HIV
- Possibly other tests, depending on any other symptoms that you may have. For example, an ultrasound scan and or x ray of the womb,
During the first visit, you may discuss the emotional stress of infertility, a subject that is often difficult for you to share with family and friends. You should always feel free to make your doctor aware of your concerns and frustrations and you should ask your doctor questions whenever you need clarification.
Continue reading for information about the Causes of Infertility
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