Achieving pregnancy is not always a simple process. Various factors—such as a woman’s age, personal or family medical history, and lifestyle—can significantly influence the fertility of a woman or a couple. That’s why it’s essential that every woman and couple seeking to have a child consult a specialized reproductive gynecologist early on. Early guidance helps ensure they receive accurate information, timely fertility testing, and appropriate treatment options when necessary.
When is a Couple Considered Infertile?
A couple is considered infertile when they have not achieved pregnancy after one year of regular, unprotected intercourse.
If the woman is over 35 years old, it is recommended to consult a fertility specialist after six months of trying, as fertility naturally declines with age.
Infertility may be caused by:
- Female reproductive system factors
- Male reproductive issues
- A combination of both
- Or may remain unexplained despite thorough evaluation
Fertility Testing for Women
A thorough fertility evaluation starts with:
- A gynecological examination
- A detailed medical and reproductive history
Based on the initial consultation, your doctor may recommend a series of targeted fertility tests, including:
Ovulation Check
- Hormones tested: LH (luteinizing hormone) and progesterone
- Purpose: To confirm whether ovulation is occurring
- Timing: LH surges just before ovulation; progesterone increases afterward
Hysterosalpingography (HSG)
- What it is: An X-ray test using contrast dye to assess the uterus and fallopian tubes
- Purpose: Detects blockages or abnormalities that may prevent fertilization
- Outcome: Minor abnormalities can sometimes be corrected surgically
Laparoscopy
- Procedure: A minimally invasive surgery under general anesthesia
- Purpose: Directly examines the uterus, ovaries, and fallopian tubes
- Useful for detecting: Endometriosis, cysts, fibroids, adhesions, or scar tissue
Hormonal Profile
- Tests may include: FSH, LH, AMH (Anti-Müllerian Hormone), TSH (thyroid), and prolactin
- Purpose: Evaluates ovarian reserve and hormonal balance critical for ovulation
Genetic Testing
- Purpose: Identifies inherited conditions or chromosomal abnormalities affecting fertility
- Examples: Karyotype analysis, mutation screening for conditions like thalassemia or cystic fibrosis
Pelvic Ultrasound
- Purpose: Visualizes the uterus and ovaries
- Detects: Fibroids, ovarian cysts, polyps, or other structural issues
Fertility Testing for Men
Male fertility testing begins with:
- A detailed medical and sexual history
- A physical examination of the genitals
Based on initial findings, the doctor may suggest:
Semen Analysis (Spermogram):
- Assesses:
- Sperm count, motility, and morphology
- Presence of infection or blood in the sample
- Why it matters: Identifies most common causes of male infertility
Hormonal Testing:
- Measures levels of:
- Testosterone
- FSH
- LH
- Prolactin
- Purpose: Determines hormonal imbalances that may affect sperm production
Scrotal & Transrectal Ultrasound
- Scrotal ultrasound: Evaluates testicles and the spermatic cord for varicocele, cysts, or blockages
- Transrectal ultrasound: Visualizes the prostate and seminal vesicles to detect obstruction or ejaculatory problems
Genetic Testing:
- Purpose: Detects chromosomal or genetic issues that may impact fertility
- Common tests: Karyotyping, Y-chromosome microdeletion testing, and CFTR gene mutation screening (linked to cystic fibrosis)
Antisperm Antibodies Test
Purpose: Checks if the man’s immune system is producing antibodies against his own sperm, which can reduce motility and function
Why Early Fertility Testing Matters
Early evaluation by a reproductive specialist can:
- Uncover hidden causes of infertility
- Allow time-sensitive treatment options
- Increase the chances of successful conception
- Reduce emotional and financial stress caused by uncertainty or delay