Fertility evaluation of females and males
Fertility evaluation of a female
Fertility evaluation of the female partner consists of assessment and series of tests of the female to determine the cause of infertility, her reproductive health and to assess her fertility potential. These are usually conducted by an infertility specialist or a reproductive endocrinologist. Some of the common components are
1. Medical history– this consists of the pattern of the menstrual cycle, the number of days of bleeding, the gap between the two cycles, any bleeding which happens inbetween. History about any previous pregnancies, abortions, ectopic pregnancy. Whether the couple has any problem in intercourse, history of sexually transmitted diseases, any past surgeries, any treatment taken for infertility and other relevant medical conditions.
2. Physical examination– to check for any abnormalities in the reproductive organs, vagina, uterus, ovaries or fallopian tubes. The general physical examination of the female is also done.
3. Hormonal assessment– blood tests for insight into the ovarian function and menstrual cycle. These are FSH, LH, estradiol, progesterone, and most important of these is the AMH (antimullerian hormone).
4. Ultrasonography- Transvaginal ultrasound (TVS) to assess the uterus and ovaries for any structural abnormalities or ovarian cysts. Follicular monitoring is done to track follicular growth and ovulation
5. Tubal evaluation– to test for the patency of the fallopian tubes an X ray of the tubes or transvaginal sonosalpingography is done to check for blockage or abnormality.
6. Endoscopy– laparoscopy or hysteroscopy maybe done to visualize the reproductive organs directly
7. Genetic screening- Genetic testing may be recommended to identify any potential genetic disorders that could affect fertility or be passed on to offspring.
8. Other specialised tests- tests for autoimmune disorders, thrombophilia, sugar, thyroid are also be done
Evaluation of male partner
Fertility evaluation of a male partner, helps assess the male partner's reproductive health and the quality of his sperm. The main aspects for evaluation are:
- Semen analysis: The most common test for evaluation of a male is a semen analysis. The analysis includes the number of sperms in the sample, motility of the sperms (the ability of sperm to move), and morphology of the sperms (the shape and structure of sperm). The semen sample is also analysed for the presence of any infection or abnormalities.
- Medical history: the male partner's medical history is taken in detail, including any past surgeries, infections, or medical illnesses (like diabetes, high blood pressure etc) any addictions that may affect fertility.
- Physical examination: A physical examination is conducted to assess the reproductive organs for any abnormalities, infections or signs of conditions that could impact fertility.
- Hormone testing: Blood tests are done to measure hormone levels, which include testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin. All these hormones play an important role in sperm production.
- Additional tests: Depending on the results of the initial evaluation, other specialised tests may be recommended. These tests include genetic testing to identify any potential genetic abnormalities. Other specialized tests to assess sperms like DNA fragmentation may also be done.
Fertility evaluations for both the female and male are usually conducted together as part of a comprehensive assessment of a couple's fertility potential. This approach allows the doctors to identify any potential issues that may affect conception and develop an appropriate treatment plan for them. It is very important that the couple should consult with a fertility specialist or reproductive endocrinologist rather than wasting time so that they can receive personalized guidance based on individual circumstances.
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