Since at least 25% of infertile couples have more than one factor causing infertility, it is important to evaluate all factors that may affect both partners. Both husband and wife should try to attend the first meeting since infertility is a shared experience and is best dealt with as a couple.
During this visit, they will begin to understand the degree of commitment and cooperation that an infertility investigation and treatment requires.
Preliminary Investigations and Fact Finding
A thorough review the couple’s history, asking both partners questions to help identify potential causes for their difficulty in conceiving. Patients should expect questions concerning prior pregnancies, miscarriages, operations, and methods of contraception. They’ll be asked how long they’ve been trying to conceive, how often they have sexual intercourse, and if anyone in either family has birth defects.
The doctor will ask about the frequency and regularity of the women’s menstrual period, pelvic pain, abnormal vaginal bleeding or discharge, history of pelvic infection, or illnesses or surgeries in the past.
The male partner will be asked questions concerning prior genital injury, surgery, infections, drug and/or medication use, history of fathering other children, and medical illnesses. The doctor will need to know the complete reproductive histories of both partners, including any former relationships.
A physical examination of the male and female partner may follow the initial review. The occurrence and extent of the examinations will depend upon whether or not any factors impacting their fertility are found early in the evaluation.
Both partners might undergo a series of tests. Sometimes this may require a significant amount of time but the results are invaluable. These tests may include:
- Routine Blood- and Urine workup
- Blood test for both partners to screen of sexually transmitted diseases and HIV
- A sperm test (semen analysis) of the male partner
- An ultrasound scan of the womb and ovaries
- A contrast X ray of the womb to determine whether the fallopian tubes are open
- Hormone blood tests: Testosterone in the male and Estrogen, Progesterone and LH and FSH in the female partner. Other hormones possibly of influence include Thyroid hormone and Prolactin.
- Possibly other tests, depending on any other symptoms that you may have
During the first visit, patients may discuss the emotional stress of infertility, a subject that is often difficult to share with family and friends.
Patients are encouraged to feel free to make their doctor aware of their concerns and frustrations and they should ask questions whenever they need clarification.