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Page: Diagnosis and Tests
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Male Infertility
The diagnosis of infertility begins with a medical history and physical exam. The provider may order blood tests to look for hormone imbalances or disease. A semen sample may be needed. The volume of the semen is measured, as well as the number of sperm in the sample. How well the sperm move is also assessed.
The cornerstone of the male partner evaluation is the history. It should note the duration of infertility, earlier pregnancies with present or past partners, and whether there was previous difficulty with conception.
A complete examination of the infertile male is important to identify general health issues associated with infertility. For example, the patient should be adequately virilized; signs of decreased body hair or gynecomastia may suggest androgen deficiency.
The scrotal contents should be carefully palpated with the patient standing. As it is often psychologically uncomfortable for young men to be examined, one helpful hint is to make the examination as efficient and as matter of fact as possible.
The peritesticular area should also be examined. Irregularities of the epididymis, located posterior-lateral to the testis, include induration, tenderness, or cysts.
Female Infertility
Diagnosis of infertility begins with a medical history and physical exam. The healthcare provider may order tests, including the following:
* an endometrial biopsy, which tests the lining of the uterus
* hormone testing, to measure levels of female hormones
* measurements of thyroid function (a thyroid stimulating hormone(TSH) level of between 1 and 2 is considered optimal for conception)
* laparoscopy, which allows the provider to see the pelvic organs
* measurement of progesterone in the second half of the cycle to confirm ovulation
* Pap smear, to check for signs of infection
* pelvic exam, to look for abnormalities or infection
* a postcoital test, which is done after sex to check for problems with secretions (not commonly used now because of test unreliability)
* special X-ray tests
Diagnosis of infertility should be made by physicians who are fellowship trained as reproductive endocrinologists. Reproductive Endocrinologists are usually Obstetrician-Gynecologists with advanced training in Reproductive Endocrinology & Infertility (in North America). These highly educated professionals and qualified physicians treat Reproductive Disorders affecting not only women but also children, men, the postmenopausal woman. These specialized professionals treat primarily, infertility for both sexes.
Prospective patients should note that reproductive endocrinology & infertility practices do not see women for general maternity care. The practice is primarily focused on getting their patients pregnant.
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Important notice:
The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other
qualified health provider with any questions you may have regarding a medical condition.
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