Workup of an infertile couple

The workup of an infertile couple involves a systematic evaluation to identify the underlying causes of infertility.
By systematically evaluating these factors, your Gynaecologist can identify the underlying causes and develop an appropriate treatment plan tailored to the couple's needs. 

The process involves the following:

  1.  Medical history and physical examination: The workup typically begins with a thorough medical history and physical examination of both partners. This helps identify any preexisting medical conditions, previous surgeries, or lifestyle factors that could affect fertility.
  2. Hormonal evaluation: Hormonal imbalances can contribute to infertility. Both male and female partners may undergo hormone tests to assess the levels of reproductive hormones such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone, testosterone, and thyroid-stimulating hormone (TSH). 
  3. Semen analysis: Male partners undergo a semen analysis to assess the quality and quantity of sperm. This includes evaluating sperm count, motility (movement), morphology (shape), and other parameters. 
  4. Ovulation assessment: For female partners, ovulation assessment is crucial to determine if ovulation is occurring regularly and if there are any abnormalities. This may involve tracking menstrual cycles, measuring basal body temperature, or using ovulation predictor kits. In some cases, additional tests like progesterone levels or ultrasound monitoring may be performed.
  5. Imaging studies: Transvaginal ultrasound is commonly employed to assess the uterus, ovaries, and fallopian tubes. It can help detect abnormalities such as polyps, fibroids, ovarian cysts, or structural issues that may hinder fertility.
  6. Hysterosalpingography: This is a specialized X-ray procedure in which a contrast dye is injected into the uterus, and X-rays are taken to evaluate the shape and patency of the fallopian tubes. It can identify blockages or abnormalities in the fallopian tubes that may prevent the sperm from reaching the egg.
  7. Genetic testing: In some cases, genetic testing may be recommended to identify any chromosomal abnormalities or genetic disorders that could impact fertility. This may include karyotype analysis, testing for specific gene mutations, or carrier screening.
  8. Other specialized tests: Depending on the specific circumstances, additional tests may be performed, such as hysteroscopy (visual examination of the uterus), laparoscopy (minimally invasive surgery to examine the pelvic organs), or immune system evaluations.
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