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Infertility testing

If you and your partner have been having trouble getting pregnant, it's possible that one or both of you has a medically treatable fertility problem. As you decide whether to look for a cause, you will have various medical and personal questions to consider.  It offers basic facts about infertility, testing, and when testing is appropriate. You can also use it to define your personal goals, feelings, and values about infertility testing and treatment.

Consider the following when making your decision:

    * If you are younger than 30 and trying to conceive, most doctors recommend well-timed intercourse for at least a year before considering testing and treatment.
    * If you (woman) are closer to 35, it's reasonable for both you and your partner to consider testing for treatable causes of infertility sooner, before age-related factors make it too difficult to conceive.
    * Infertility testing and treatment can be difficult, sometimes traumatic, and expensive. Before starting infertility testing together, discuss how far you would be willing to go with testing and treatment. Only have testing for conditions that you are willing and financially able to have treated or that would help you move on to other options such as adoption.
    * Prolonged infertility testing and treatment can intensify the stress of infertility. If you are becoming overly stressed or your relationship is suffering, ask your doctor to recommend a professional counselor who can help you get through this crisis together.
    * As a couple, you have the final word on how to use your infertility test results based on your medical information, goals, and values.

Medical Information
What is infertility?

Infertility is defined as a couple's inability to become pregnant after 1 year of sex without using birth control. But "normal fertility" is defined as the ability to naturally conceive within 2 years' time.

A man's fertility is not known to be severely affected by age. A woman's fertility gradually drops from her mid-30s into her 40s, due in great part to the natural aging of the egg supply. For any couple, defining infertility is a personal issue—influenced by a woman's age and how much time a couple chooses to try conceiving without medical intervention.
What causes infertility?

In about 35% of couples, testing reveals a male fertility problem, as with sperm production or ejaculation. In about 50% of couples, the primary cause is a female fertility problem with ovulation, fallopian tube function, or other pelvic problems, such as endometriosis. Some couples find that both partners have a fertility problem. In 10% of couples, no cause of infertility is found.
What types of infertility testing are available?

Testing for causes of infertility can range from simple, inexpensive, and painless to complicated, expensive, and surgically invasive. If you decide to test for a cause of infertility, your doctor will want to check both of you at the same time. Using your fertility awareness information, semen analysis, and blood tests for hormone levels, your doctor can easily check for the most common male and female infertility problems.

    * Initial tests of male and female hormone and semen analysis can signal problems with egg or sperm production. Typically, an abnormal sperm analysis will be followed by a repeat analysis. Depending on the problem, abnormal hormone or sperm results are followed up with further testing or treated with medicines or hormones.
    * Tests that examine the reproductive tract, such as hysteroscopy, hysterosalpingogram, sonohysterogram, endometrial biopsy, ultrasound, laparoscopy, and transrectal ultrasound, can identify disease or structural problems that might be reversible.