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 Finding the Cause of
your Infertility
So you've decided it's time to see a fertility
specialist. What should you expect_
The first thing he/she will do is take a complete medical
history of yourself and your husband and perform a gynecological exam. Then a
number of tests will be recommended. This is known as the "fertility
evaluation."
Your evaluation will include a semen analysis for
your husband (in which the number and condition of his sperm are assessed) and some blood
tests to measure your hormone levels: FSH and estradiol (done on "day 3"
of your menstrual cycle), progesterone (done near the end of the menstrual cycle), thyroid
and prolactin.
A "post-coital test" (similar to a pap smear)
will be done at mid-cycle to assess, under a microscope, the reaction between the sperm
and vaginal mucus. At the same time, some of the cells obtained can be sent to
a laboratory to rule out pelvic infections such as chlamydia or Ureaplasma.
A hysterosalpingogram (sometimes known as "HSG"
or simply "tubal x-rays") will assess the condition of your uterus and fallopian
tubes and an endometrial biopsy (in which a tiny amount of tissue is taken from the
lining of your uterus and examined in a laboratory) will tell your doctor whether your
womb is preparing properly for pregnancy following ovulation.
If indicated, your doctor may also recommend laparoscopy
and/or hysteroscopy. These are outpatient diagnostic procedures which can identify
pelvic adhesions, endometriosis, and various problems of the uterus and fallopian tubes.
Having completed all these tests, there is about a 95%
probability that your doctor will be able to pinpoint the cause of your infertility.
And once this is done, you can proceed to treatment and - hopefully - a successful
outcome.
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