Evaluation of an Infertile Female
Infertility:
Infertility Means Not Being Able To Get Pregnant After One Year Of Regular, Unprotected Intercourse (Or 6 Months If A Woman Is 35 Or Older). Some Women Get Pregnant Easily But Miscarry The Child - They Also Are Considered Sub-Fertile. About One Third Of Infertility Cases Are Caused By Female Problems.
What Causes Infertility In Women:
Women Need Functioning Ovaries, Fallopian Tubes And A Uterus To Get Pregnant. Conditions Affecting Any Of These Organs Can Contribute To Female Infertility.
A Woman’s Menstrual Cycle Is On An Average 28 Days Long. Day 1 Is Defined As The First Day Of Full Flow. If You Get Your Periods Between 24-35 Days That Implies You Are Ovulating Regularly. A Woman With Irregular Periods Is Likely Not Ovulating.
Fertility Tests May Include;
Ovulation Testing: An At Home, Over The Counter Urinary Ovulation Prediction Kit Detects The Surge In A Hormone Called Luteinizing Hormone {Lh} Which Occurs One Or Two Days Before Ovulation. A Blood Test For Progesterone - A Hormone Produced After Ovulation On Day 21 Of Your Menstrual Cycle Can Also Document Ovulation. Ovulation Can Also Be Documented By Serial Mid-Cycle Follicular Transvaginal Ultrasonography.
What Is Ovarian Reserve Testing:
It Is A Way To Test Your Reproductive Potential In Terms Of Quantity And Quality. Women Who Have Risk Of
Diminished Egg Supply, Including Women Older Than 35 Years Of Age May Need To Have Their Ovarian Reserve Tests Done. The Most Commonly Used Markers Of Ovarian Function Include The Anti-Mullerian Hormone (Amh) And The Antral Follicle Count (Afc) Using A Transvaginal Ultrasound During The Early Part Of A Menstrual Cycle. In Addition Your Physician May Recommend Other Blood Tests Such As Estradiol Or Inhibin B.
Other Hormone Testing:
Thyroid Stimulating Hormone (Tsh) And Prolactin (Prl) Levels Are Also Useful To Identify Thyroid Disorders And Hyperprolactinemia, Which May Cause Problems With Fertility, Menstrual Irregularities And Repeated Miscarriages. In Women Who Are Thought To Have An Increase In Hirsutism (Excess Hair On The Face And /Or Down The Middle Of The Chest Or Abdomen), Blood Tests For Dehydroepiandrosterone Sulphate (Dheas), 17-Hydroxyprogesterone And Total Testosterone Should Be Considered.
Tubal Factor Evaluation:
Risk Factors For Blocked Fallopian Tubes (Tubal Occlusion) Can Include A History Of Pelvic Infection, History Of Ruptured Ectopic, History Of Gonorrhoea Or Chlamydia, Known Endometriosis Or A History Of Abdominal Surgery. Tubal Evaluation Maybe Performed By Using:
1. Hysterosalpingogram (Hsg): This Is An X-Ray Of The Uterus And Fallopian Tubes. A Radiologist Injects Dye Into The Uterus Through The Cervix And Simultaneously Takes An X-Ray Picture To See If The Dye Moves Freely Out Of The Fallopian Tubes. This Helps Evaluate The Tubal Calibre (Diameter) And Patency.
2. Chromopertubation-: This Is Similar To An Hsg But Is Done In The Operating Room At The Time Of Laparoscopy. Blue Coloured Dye Is Passed Through The Cervix Into The Uterus And Spillage And Tubal Calibre Are Evaluated.
4. Saline Sonosalpingogram: A Health Care Provider Injects Saline Into The Cervix To Fill The Uterus And The Fallopian Tubes And The Spillage Is Visualized With Transvaginal Ultrasound.
Uterine Factor Evaluation:
1. Transvaginal Ultrasound (Tvs): An Ultrasound That Looks At The Internal Organs Using Sound Waves By A Probe Placed In The Vagina To Check For Abnormalities Like Fibroids, Uterine Anomalies And Ovarian Cysts.
2. Hysteroscopy: This Is A Surgical Procedure In Which A Lighted Telescope-Like Instrument (Hysteroscope) Is Passed Through The Cervix To View The Inside Of The Uterus. Hysteroscopy Can Help Diagnose And Treat Abnormalities Inside The Uterine Cavity Such As Polyps, Fibroids And Adhesions (Scar Tissue).
3. Laparoscopy: The Lighted Telescope-Like Instrument (Laparoscope) Is Inserted Beneath The Navel After A Small Cut To View The Fallopian Tubes, Ovaries And Uterus And The Whole Abdomen. This Can Help To Identify Can Identify Endometriosis, Scarring, Blockages Or Irregularities Of The Fallopian Tubes And Problems With The Ovaries And Uterus.
4. Genetic Testing: Genetic Testing Helps Determine Whether There Is A Genetic Defect Causing Infertility.
For Best Results, The Infertility Evaluation Should Be Individualized Based On Each Woman’s Specific Circumstances.