There can be one or many causes of infertility in couples. Dr.. Borkowski will order a complete evaluation of both partners to rule out potential causes of infertility. Infertility specialists undergo extensive advanced training enabling them to properly interpret fertility test results and prescribe appropriate treatments.
Conditions such as “irregular ovulation” may be obvious; however, there can be other underlying causes of infertility such as endometriosis, tubal obstruction, male infertility, etc. All of these must be ruled out prior to beginning treatments. Male Fertility will be Evaluated Prior to Treatment of the Female.
Fertility tests evaluate the many processes that must occur in order for pregnancy to result. We discuss these tests in detail on separate pages of the Web site. In general terms, infertility tests can be categorized as follows:
- Ovarian- there must be “healthy” eggs capable of fertilization and development. Tests to evaluate ovarian function include hormone measurements such as the day 3 FSH level. “Quality ovulation” must occur each month to maximize the chances of pregnancy. Other hormones that will be evaluated include estradiol, progesterone, thyroid hormones, androgens, and others.
- Tubal- the eggs must travel unimpeded from the ovary to the site of fertilization in the distal (end away from the ovary) portion of the Fallopian tubes. Blockage of the tubes by endometriosis, pelvic inflammatory disease, etc. can prevent the eggs from making this transition. Tests such as the hysterosalpingogram and laparoscopy are used to evaluate the Fallopian tubes.
- Uterine- the uterus must be free of large obstructions that can be caused by fibroids or polyps. Many times these obstructions will be removed prior to other fertility treatments. The uterus must be “normally” shaped and free of abnormalities that can be congenital.
- Cervical- Sperm are ejaculated into the vagina and swim in the cervical mucus through the cervix into the uterus. The cervical mucus must have the correct consistency and be free of antisperm antibodies. Tests to evaluate the cervical mucus include the post coital test.
- Endometriosis is a common cause of infertility. Endometrial cells attach to the reproductive organs and can cause blockage and scarring. Endometriosis is diagnosed by laparoscopy.
- All male partners must undergo a semen analysis. This test evaluates the quantity and quality of sperm present. Parameters evaluated include the number of sperm, how they swim, their shape, viscosity, and many other factors. No treatment of the female should be initiated until the semen analysis has been evaluated.