Infertility Evaluation, Testing and Treatment
Infertility is defined as when a couple has been trying to become pregnant for at least a year without success. This experience can be confusing, frustrating and emotional. The healthcare providers at our practices are available to determine the cause of infertility and to develop a plan for treatment that works for you. Learn more about our approach here.
Conditions Affecting Infertility
All women are born with a fixed number of eggs for reproduction. As their age increases, the number and quality of eggs decrease. Statistically, the chances of becoming pregnant decrease by about 3% to 5% per year once they reach the age of 30. After age 40, the decline in fertility is considerably greater. Besides the ongoing reduction in the number and quality of eggs a woman has after she reaches 30, other factors can negatively impact fertility, such as:
- Fallopian tube damage
- Hormonal causes
- Cervical causes
- Uterine causes
- Unexplained causes
Diagnosing Female Infertility
When the female is suspected of being infertile, physicians have several tests and procedures to confirm a diagnosis. These include:
- A blood test to check hormone levels and other conditions, including, among others, those affecting the thyroid
- An endometrial biopsy to check the lining of the uterus
- Additional diagnostic tests to determine if scar tissue or fallopian tube obstruction is present, such as:
- Hysterosalpingography – a procedure that uses either ultrasound or X-ray images of the reproductive organs to determine if the fallopian tubes are blocked.
- Laparoscopy – a minimally invasive procedure where a laparoscope is inserted into the abdomen through a small incision near the belly button to view the outside of the uterus, ovaries and fallopian tubes to detect abnormal growths (endometriosis).
- Ovarian Reserve Testing – a test to determine a woman’s ovarian reserve to predict whether she can produce an egg or eggs of good quality and how her ovaries are responding to hormonal signals from her brain.
- Urinary Luteinizing Hormone (LH) Testing – A specialized urinary test to help define the times of peak fertility by predicting ovulation before it occurs.
Treating Female Infertility
There are many fertility drugs available to treat female infertility. Some of the more common oral and injectable medications used by gynecologists to treat female infertility include:
- Clomiphene Citrate (Clomid) – is an oral medication affecting the pituitary gland that causes ovulation. It is frequently used in women who have polycystic ovarian syndrome (PCOS) or other ovulation problems.
- Human Menopausal Gonadotropin or hMG (Repronex or Pergonal) – an injectable medication for women with pituitary conditions that preclude them from ovulating. It acts directly on the ovaries to stimulate ovulation.
- Follicle-Stimulating Hormone or FSH (Gonal-F or Follistim) – is usually given via injection, FSH works much like hMG in that it causes the ovaries to begin the ovulation process.
- Gonadotropin-Releasing Hormone (Gn-RH) analog – delivered via injection or nasal spray; these medications are used on women who don’t ovulate regularly. They are also helpful for women who ovulate before an egg is ready. They act on the pituitary gland and change when the body begins to ovulate.
- Metformin (Glucophage) – is usually given orally to women with insulin resistance or PCOS. It helps to reduce high levels of male hormones in women to help the ovulation process.
- Bromocriptine (Parlodel) – is a medication for women with ovulation problems due to high levels of prolactin, which can cause menstrual disturbances. It is given orally or as an injectable to lower prolactin levels and allow the ovaries to function normally.
It is necessary to be aware that fertility drugs can increase the potential of having twins, triplets, or other multiples. Women should be aware that pregnancies with multiple fetuses can have more problems during pregnancy.
Additionally, multiple fetuses have a high risk of premature birth and are at an increased risk of problems associated with overall health and development.
Schedule Your Appointment
If you and your partner have been trying to conceive naturally for a year or more without success, infertility treatment may help you with starting a family. Contact the caring team at our practice to schedule an appointment.