In general, we begin evaluating a couple for infertility treatment and testing if you have not conceived after one year of frequent, unprotected intercourse.
You may think about being seen sooner for family planning if:
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You are 35 or older and have not gotten pregnant after 6 months of frequent unprotected intercourse
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You are 40 years old
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You have a history of infertility or needed fertility assistance in a prior pregnancy
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You have irregular or infrequent periods
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You have previously been treated for cancer
Your partner may consider being evaluated if:
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He has had prior scrotal surgery
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Has a known fertility problem
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Has previously been treated for a cancer
Day 3 Lab Tests:
Performed on the 3rd day after your period starts. Performing the test on day three lets us evaluate the hormones the ovary produces. Other, tests are evaluated at this time that do not depend on where you are in your cycle.
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Thyroid stimulating hormone
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Prolactin
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Follicle stimulating hormone
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Estradiol
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Antimullerian hormone – evaluates ovarian reserve. This helps evaluate the quality and quantity of eggs available for ovulation.
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Sexually transmitted disease testing.
Day 21 Labs; Progesterone:
Assesses if you are ovulating
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Ultrasound – Evaluates the uterus and ovaries for fibroids or cysts
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Hysterosalpingography – An x-ray study that evaluates if the fallopian tubes are healthy and open as well as evaluating the inside cavity of the uterus.
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Semen Analysis – Evaluates the quality and quantity of semen.
The evaluation you have is individual. You may have some or all of these tests performed. Occasionally, additional testing is performed. If you are interested in testing for genetic conditions, i.e. cystic fibrosis or sickle cell disease this is a very good time to perform these tests. Talk with your doctor if you are interested.
Fertility Treatment Options
There are many treatment options and treatment depends on the cause of infertility. For women treatment usually involves stimulating ovulation with fertility drugs, intrauterine insemination or surgery to treat a structural problem like an endometrial polyp or a uterine septum. Male factor infertility frequently involves the semen – either a low volume of sperm or the sperm does not move well. Intrauterine insemination can overcome these issues. Occasionally, men may need a surgical procedure to correct a problem like a varicocele.