Fertility Evaluation

Fertility Evaluation of Female partners is done to identify potential factors that may affect the ability to conceive. Fertility evaluations for women typically involve a combination of medical history assessments, physical examinations, and various laboratory tests.

Here is a list of common investigations for female fertility evaluation:

Medical History: A comprehensive overview of the woman’s reproductive health, including menstrual history, contraceptive history, and any previous pregnancies.

• Menstrual Cycle Assessment: Tracking the menstrual cycle to identify irregularities in cycle length, ovulation, and potential hormonal imbalances. Ovulation Tracking via ultrasound monitoring to assess the regularity of ovulation.
• Hormonal Tests: Measurement of hormone levels, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone hormones. This is not needed routinely but only in selected cases.
• Ovarian Reserve Testing: Assessment of the quantity and quality of a woman’s remaining eggs. This may include tests like anti-Müllerian hormone (AMH) and antral follicle count (AFC).
• Tubal Patency Testing:Tubal factor infertility (blocked or damaged Fallopian tubes) are seen in 25-30% of Female Infertility cases. There are different methods of testing for patency:
  • Hysterosalpingography (HSG): This is an X-ray procedure to evaluate the patency of the fallopian tubes and identify any abnormalities in the uterine cavity. It involves inserting a cannula inside the uterus via the cervix and passing a radio-opaque dye into the uterus. As the dye passes through the tubes and spills out of the openings, a series of x-rays are shot to visualize this. It can help identify tubal blockage and abnormalities in uterine shape and anatomy. It is the oldest method; it is a painful method and has the risk of radiation exposure.
  • Sonohysterography / Hysterosalpingography: This is an ultrasound procedure, like HSG, but much safer and less painful. A saline solution is passed inside the uterus under ultrasound guidance. It not only helps assess the tubes but also helps assess the uterine cavity for abnormalities such as polyps, fibroids, or adhesions.
• Pelvic Ultrasound: Ultrasound Imaging of the pelvic organs, including the uterus and ovaries, to check for structural abnormalities or ovarian cysts.
• Thyroid Function Tests: Assessment of thyroid hormones to rule out thyroid dysfunction, which can affect fertility.
• Blood Glucose and Glycosylated Hemoglobin: Screening for conditions like polycystic ovary syndrome (PCOS) and/or diabetes that may impact fertility.
• Infectious Disease Testing: Screening for sexually transmitted infections (STIs) that can affect reproductive health.