Being unable to start a family is among the most frustrating issues a couple can face. If after a year of trying there is still no pregnancy, fertility testing should be started to determine the source of the problem. At Virginia Beach OBGYN, our physicians have assisted countless couples achieve their dream of parenthood by discovering and treating their infertility challenges.
Comprehensive physical exam is the first step
Early fertility testing involves both partners beginning with a thorough physical exam and a frank talk with one of our fertility specialists. Questions will cover issues such as lifestyle, drug and alcohol consumption, contraception choices, prior pregnancies, menstrual history, past sexual practices. Work environment will also be discussed. This comprehensive history provides information that may shed some light on what the problem may be.
One of the earliest fertility tests usually done is an evaluation of semen. It has been found that infertility problems originate due to male health factors in about half of the cases seen in our practice. This test can be done at home using a kit, making it easier to provide a sample.
For the woman, a pelvic exam with a pap test will be done as a starting point followed by fertility testing as needed. At Virginia Beach OBGYN, we begin by ordering the least invasive tests and should these not provide our fertility doctors with answers, more sophisticated testing is done until there is a definite conclusion.
A comprehensive physical evaluation of both partners will also discover other medical conditions that may be hindering conception. Once diagnosed, these conditions can be treated which prepares the way for future attempts at pregnancy.
Ovulation
Determining if ovulation is occurring is part of early phase testing. This can initially be monitored at home using a fertility monitor or by tracking body temperature using a specially graded basal thermometer. Ovulation has two elements to evaluate; whether it is occurring at all and how the reproductive hormones are functioning at different times during ovulation.
To determine hormone function, blood tests are done to measure levels of FSH (follicle stimulating hormone) and Estradiol on Day 3 of the cycle. Ultrasound can also be used to determine if ovulation is occurring.
Other hormones that may be tested are progesterone, prolactin, T3 (a thyroid hormone) luteinizing hormone (LH) which triggers ovulation and several others. Some, or all, of these specialized hormone tests will be a key factor in fertility testing done at our clinic. Since timing is crucial in many of these tests, having a nearby clinic makes adhering to the specific schedule relatively easy.
Fertility testing of physical structure
Achieving pregnancy requires that the sperm be able to fertilize an egg and that the egg is able to implant successfully into the endometrium, or the lining of the uterus.
Physical testing will involve several tests beginning with a post coital test to determine if sperm can penetrate the cervical mucus. This test is timed a few hours after intercourse to check the viability of the sperm in the environment. Infection can prevent the passage of sperm into the uterus and this test will determine if there is a bacterial infection present.
Ultrasound can be used to evaluate the lining of the uterus and to discover if an egg has been released. If prior fertility testing has returned normal results and pregnancy has not been achieved, there are other tests that can be ordered.
These tests can include:
X-ray of the uterus and fallopian tube using a dye injected into the uterus and fallopian tubes.
Hysteroscopy of the uterus provides a real time view of the interior of the uterus, fallopian tubes and any obstructions that may be present. The hysteroscope can also take pictures.
Laparoscopy involves inserting a fiber optic telescope through a small incision in the abdomen. This allows a view of the uterus, fallopian tubes and the ovaries. During this procedure any scar tissue or other abnormalities can be removed using a laser.
Biopsy of the endometrium – timed to occur just prior to menstruation to evaluate the condition of the lining of the uterus.
Schedule a fertility evaluation
Being unable to conceive a child is a frustration that 1 in 6 couples face in America. There are many ways of detecting and handling infertility and they all begin with an initial appointment at one of our convenient Virginia Beach and area locations.