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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 brief physical evaluation, interview about the past 3 months, 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 basic infertility evaluation
is much more involved. The entire evaluation is designed to answer 3 of the 4 most basic questions:
1. Is there an egg?
2. Is there sperm?
3. Is anything physically preventing the sperm and egg from getting together?
4. When together, does the sperm fertilize the egg?
The only true test for question number 4 is IVF (in vitro fertilization).
Tests Associated with Each Question
1. Is there an egg?
Temperature charts, LH kits and sometimes a progesterone test can be used to estimate if there is ovulation.
Additionally, many physicians like to use an ultrasound to see if a follicle has actually ruptured, presumably
releasing an egg. There are other tests, like checking prolactin and thyroid stimulating hormone levels, to rule
out more rare circumstances, which are easily treatable.
2. Is there sperm?
A semen analysis is needed.
3. Is anything physically preventing the sperm and egg from getting together?
Sometimes cervical mucus can create a hostile environment for sperm survival. This is checked with a cervical
mucus test and/or a post-coital test. Ultrasound may show obvious 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.
4. When together, does the sperm fertilize the egg?
IVF is the only true test for fertilization.
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