The definition of infertility is the inability to conceive after 12 months of unprotected sexual intercourse, as 85% of couples will become pregnant within 1 year. Infertility can be due to a variety of reasons. Once a couple has been diagnosed with difficulty conceiving, a doctor will perform tests to determine the cause or causes.
- Male Factor - Absence or abnormal sperm count or characteristics
- Ovarian Factor - Absence or irregular ovulation
- Tubal Factor - Occlusion and/or scarring of the fallopian tubes from prior surgery, adhesions or prior infection
- Uterine factor - Abnormality of uterine cavity (i.e. fibroid, polyp)
There are three conditions that must be met for conception to be possible:
- Sperm must be present
- The fallopian tubes must be open
- Ovulation must be able to occur
If one or more of these conditions is compromised, infertility is diagnosed. Initial evaluations are individually tailored to each patient and couple, but there are a few standard tests performed to evaluate these three critical factors. These include measurements of the hormones that regulate ovulation and egg quality, imaging tests of the fallopian tubes and semen analysis (specifically volume, sperm count, sperm motility and morphology).
For about 10-20% of couples experiencing problems conceiving, even with a thorough evaluation, a cause of infertility will not be determined. This is called unexplained infertility and may be caused by intermittent symptoms such as variable sperm count, irregular ovulation or by other factors which we don’t yet understand or have developed a test to screen for the condition. Some couples with unexplained infertility successfully conceive after treatment or even without treatment.
We offer a variety of basic infertility services, including:
- Consultation visit to determine risk factors for infertility and to develop an evaluation and management plan.
- Induction of Ovulation - The use of hormones to assist ovulation and maintain hormone levels necessary for a successful pregnancy.
- Tubal Evaluation - Laparoscopy can be performed to assess for tubal occlusion or presence of scar tissue effecting tubal patency.
- Uterine Evaluation - Trans-vaginal ultrasound (with or without instillation of saline) can be performed to assess the anatomy of the uterus and for detection of the presence of structural abnormalities such as uterine fibroids, polyps or other masses.
- Semen Analysis - Appropriate referral for semen analysis
- Intrauterine Insemination - We can perform intrauterine inseminations with either spouse or donor sperm in-office
- We also make appropriate referrals to an Infertility Specialist if further evaluation and treatment with assisted reproductive technology (ART, examples: IVF) is indicated.