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The basic infertility evaluation, sometimes called a work-up, is the testing period prior to treatment to determine diagnosis. For men, it usually consist of a medical history and a semen analysis. The semen analysis will provide results on volume, sperm count and overall sperm health. It should be stated emphatically that there is no correlation between male infertility, low sperm count and impotence. They are all different issues, but are often emotionally linked by unfounded social discussions. Determination of male fertility is usually the first, easiest and smartest starting point for basic infertility evaluations.
For women, the work-up is much more involved. The entire evaluation is designed to answer 3 of the 4 most basic questions:
- Is there an egg?
- Is there sperm?
- Is anything preventing the sperm and egg from getting together?
- When together, does the sperm fertilize the egg?
The only true test for question number 4 is In-Vitro Fertilization (IVF).
Tests Associated with Each Question
- Is there an egg?
Temperature charts, Ovulation Predictor kits and sometimes a progesterone test can be used to determine if there is ovulation. There are other tests, like checking prolactin and thyroid stimulating hormone levels, to rule out more rare circumstances, which are easily treatable.
- Is there sperm?
A semen analysis is needed.
- Is anything preventing the sperm and egg from getting together?
Ultrasound is done to see if there is any obvious interference or Endometriosis. Additionally, a hysterosalpingogram (HSG) is done to see if there is any blockage in the fallopian tubes or uterus. This is essentially an X-ray of the uterus and fallopian tubes after the injection of a dye through the cervix.
- When together, does the sperm fertilize the egg?
IVF is the only true test for fertilization.
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