As per WHO data 2023, 1 in 6 couples (approx. 17.5% of adults) experience infertility at some point in their lifetime. Infertility can be due to various factors which can be related to female, male, combined or unexplained reasons. This is why evaluating a couple simultaneously is important for reach an accurate diagnosis and plan an effective treatment. If the couple has been trying to conceive for more than a year (or 6 months if the female is over 35), it is the ideal time to consult a fertility specialist.
CONSULTATION :
The initial consultation includes a detailed medical history and lifestyle assessment of both male and female partners.
1.
Duration of Infertility
2.
Menstrual history (for the female partner)
3.
Previous pregnancies or miscarriages
4.
Sexual history – (erection or ejaculation issues)
5.
Past medical or surgical history or family history of couple
6.
Factors based on Lifestyle (smoking, alcohol, stress, etc.)
Evaluation of Female Partner
1. Physical examination
2. Ultrasound pelvis to look for uterine or adnexal pathology
3. Hormonal asssay (FSH, LH, E2, TSH, Prolactin)
4. Ovarian reserve testing
A.
AMH (Anti-Mullerian Hormone)
B.
Antral Follicle Count (via USG)
5. Ovulation Assessment –
A.
Basal body temperature
B.
Ovulation predicting LH kits
C.
Ultrasound for Follicular Monitoring
D.
Mid Luteal phase serum progesterone levels
6. Tubal Patency Evaluation
A.
HSG (Hysterosalpingography) – an X-ray with a dye
B.
Sonosalpingography – an Ultrasound with Fluid
C.
Laparoscopy – only if needed / recommended by your doctor
7. Uterine Evaluation – To look for fibroids, polyps or other abnormalities
A.
Ultrasound
B.
Hysteroscopy – a small camera to look inside the uterine cavity
Evaluation of Male Partner
1. Physical Examination
2. Semen Analysis – Done after 2 to 5 days of abstinence
A.
Volume
B.
Sperm count
C.
Sperm motility
D.
Morphology (to look for shape of sperms)
3. Hormonal testing (if needed)
A.
S.Testosterone, LH, FSH and Estradiol levels
4. Advanced testing (if required)
A.
Scrotal Ultrasound
B.
DNA Fragmentation
C.
Genetic screening in specific cases
Counselling and Personalized Plan
After evaluation, the couple needs the fertility expert to discuss.
A.
Recommended treatment options
B.
Lifestyle and dietary changes
C.
Emotional support and stress management
Early evaluation means earlier solutions whether it’s lifestyle changes, medication or Assisted Reproductive Technique like IUI or IVF, a proper diagnosis paves the way to parenthood.