Every couple should at least try for a year before approaching any infertility specialist or clinic for the same. Infertile couples might have one or more reasons for not attaining parenthood, so both the partners should approach for tests.
No doubt a woman’s reproductive system is way more complicated than a man as it nurtures life for nothing less than 9 long months. But on another hand, she might not be the sole reason for not conceiving. Men are equally responsible. Especially, the elders of the house are pro in blaming and not accepting that cause of infertility could be their son. This mindset has to change for the betterment of everyone. The process of conceiving not only depends on anatomy but also on the mental health of the woman. The blame game has to ? STOP.
Before stepping up for infertility tests it’s important that you are financially prepared for it as the tests are bit expensive. Usually, it’s not covered by insurance policies.
Diagnosing male infertility problems usually involves:
- General physical examination and Medical history.
This involves examining your genitals and asking questions about any inherited condition, chronic health problems, illness, injuries or surgeries that might affect your fertility. Your doctor may also ask about sexual habits and your sexual development during puberty.
- Semen Analysis
In this analysis, the male partner has to give his semen sample which is sent to the laboratory. Semen Analysis measures three major factors of sperm health: sperm count, sperm morphology(shape), sperm motility. The normal sperm count is 15-300 million in one millilitre of semen. Anything less than 15million/ml is considered to be low. Abnormal morphology of sperm means shapes of sperm that are not capable of fusing the matured egg, this can also lead to infertility. Sperm motility is also equally important this determines the speed at which the sperm can swim faster and reach the matured egg for fusion that stays in for a short period of 48hours in fallopian tubes.
If your sperm health is normal then your female partner is requested to go through the infertility tests.
In case if the sperm health is low or poor further investigations are carried some of which are mentioned below.
- Scrotal ultrasound – This ultrasound helps your doctor to see if there is varicocele or any other problem in testicles and supporting structures. Varicocele is the enlargement of veins within the scrotum.
- Hormone testing -A blood test measures the level of testosterone and other hormones produced by the pituitary gland, hypothalamus and testicles. These hormones play a key role in sexual development and sperm production. Abnormalities lead to infertility.
- Post-ejaculation urinalysis – Sperm in the urine can indicate your sperm are traveling backward into the bladder instead of out of your penis during ejaculation (retrograde ejaculation).
- Genetic tests. When sperm concentration is extremely low, there could be a genetic cause. A blood test reveals whether there are subtle changes in the Y chromosome — signs of a genetic abnormality. Genetic testing might be ordered to diagnose various congenital or inherited syndromes.
Diagnosing female related infertility problems mostly involves :
- Problems pertaining to Ovaries, Tubes and Uterus (Pelvic Anatomy)
Usually, ultrasound gives a fair idea to your doctor, whether you have normal or abnormal ovary and uterus. But to diagnose the fallopian tubes they are mainly three procedures;
Fallopian tubes are thin tube like structure that emerges from uterus and is connected with the ovaries. It collects mature eggs from ovaries. The eggs stay in the tube for 48 hrs before being discarded by the body, if there is no fusion with the sperm. If there is blockage, fusion is not possible so its important to find out whether the tubes are open or not.
The three key tests to diagnose Blocked fallopian tubes.
- An X-ray test, known as a hysterosalpingogram (HSG). A doctor injects a harmless dye into the womb, which flows into the fallopian tubes. The stain is visible on an X-ray. If the fluid does not flow into the fallopian tubes, there is a possibility of a blockage.
- An ultrasound test, known as a sonohysterogram. This is very similar to the HSG test but uses sound waves to build up a picture of the fallopian tubes.
- Keyhole surgery, known as a laparoscopy. A surgeon makes a small cut in the body and inserts a tiny camera to take pictures of the fallopian tubes from inside.
- There is also a single diagnostic test known as Diagnostic Hystero-laproscopy (DHL) that is more accurate and could diagnose the entire pelvic area in one go. Moreover, in this laproscopy the surgeon usually removes scar tissue or endometriosis during the surgery.
DHL is a minor laproscopic surgery which is one of the best and accurate test to find out discrepancy in entire Pelvic area but it’s little expensive than usual ultrasound and causes discomfort of laproscopic incision in the abdomen area.
Diagnostic Tests For hormonal levels
Blood test is done to know the level of hormones present in a female body. Hormones are basically messengers that orders various tissues and organs to carry out functions. The Blood Test would determine following hormone levels.
- Follicle-stimulating Hormone (FSH) – stimulates ovaries to develop follicles(eggs)
- Luteinizing Hormone (LH) – Stimulates Ovaries to release egg during Ovulation.
- Anti Mullerian Hormone (AMH)
- Serum Progesterone
- Androgen ( Male hormone)
Apart from symptoms the levels of FSH and LH hormones help the doctor to reach to a conclusion whether a patient has PCOS (Poly cystic Ovarian Syndrome) or not.
This post is to help to understand the overall diagnostic tests involved before undergoing any fertility treatment. After these test only a doctor decides on the line of treatment that he would follow for his patient.
If you like my post and find it informative then please do share it with all those who are in the same struggling phase .
You can read here the previous posts of series #TrystwithInfertility here:
“A” – Are you pregnant yet?
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