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What is an Infertility Evaluation?

An infertility evaluation is a series of tests and exams to try and determine the reason why you are not getting pregnant. Finding the cause makes it much easier to treat the problem, though many times, infertility can be treated successfully even if no concrete cause is found. Several factors can contribute to infertility, so you may want to consider undergoing an evaluation if:

  • You have not gotten pregnant after one year of regular sexual intercourse without using birth control
  • You are over the age of 35 and have not become pregnant after six months of regular sexual intercourse without using birth control
  • You have an irregular menstrual cycle
  • Either you or your partner have an existing fertility issue that you already know about

At Southern OBGYN, we understand and are sensitive to the fact that trying and failing to get pregnant can be an emotional and frustrating experience. We are here to support you through the process, and offer treatment and solutions that can help you as you begin to build the family you’ve dreamed about.

Common Causes of Infertility

Nearly 40 percent of women who suffer from infertility have irregular or abnormal ovulation, or may not be ovulating at all (a condition known as anovulation). Other factors that may prevent you from getting pregnant include:

  • Hormone problems, as well as issues with the thyroid or pituitary glands
  • Problems with the reproductive organs, such as blockages in the fallopian tubes or scarring from infection or endometriosis
  • Age – women in their 20s and early 30s typically have up to a 30 percent chance of becoming pregnant each menstrual cycle, but by age 40, that percentage drops to less than 10 percent each menstrual cycle
  • If you are overweight, underweight (causing irregular menstrual periods) or consume moderate to heavy levels of alcohol

If you are struggling to become pregnant, you may want to schedule a visit with one of our experienced doctors at Southern OBGYN for a fertility assessment.

What You Can Expect at Your First Fertility Visit

As with any initial visit, your first infertility assessment will involve a physical exam as well as a detailed medical history. Some of the questions that may be asked include:

  • Female reproductive health history – Do you have regular menstrual cycles? Do you have chronic pelvic pain, or abnormal vaginal bleeding or discharge? Have you had any past diagnoses of STDs, infections or other disorders that may affect reproduction? Have you been pregnant in the past and if so, what was the outcome?
  • Medications – What prescriptions, over the counter and herbal supplements do you use? Do you take hormone supplements or suffer from thyroid or pituitary problems?
  • Medical history – Have you had any illnesses or surgeries that may have affected your fertility?
  • Family history – Do any of your family members have a congenital birth defect or trouble getting pregnant?
  • Lifestyle – Do you use tobacco, alcohol or illicit drugs?
  • Sexual history – How long have you been trying to get pregnant? How often do you have intercourse, and are there any difficulties? What types of birth control have you used in the past?

Remember that your answers to these questions are completely confidential, and the purpose is to determine the reason behind your inability to become pregnant. It is essential that you are open and honest with your doctor so that we can compile an accurate assessment of your health. It is also vital to keep in mind that infertility evaluation is a process, and it typically takes a few menstrual cycles to complete a comprehensive assessment.

Types of Fertility Testing

There are several ways to test for infertility, including lab tests, imaging tests, and diagnostic procedures. Laboratory tests typically test blood and urine, and may include:

  • Urine test – When you ovulate, there is an increase in the levels of luteinizing hormone (LH) in your urine. When LH levels surge, it triggers the release of an egg. If the test is positive, it means that you will most likely ovulate within the next 24-48 hours. By testing your urine, we can determine if and when you are ovulating so that you can get an idea of the best time to have sex to try and get pregnant.
  • Thyroid function – Problems with your thyroid gland may cause infertility, as an underactive thyroid can inhibit ovulation. If it is suspected that you have an underactive thyroid, treating that condition can increase your chances of getting pregnant.
  • Progesterone level – This blood test is done about a week before you are expecting your period. The levels of progesterone are measured, and if they are elevated, it means you have ovulated.
  • Prolactin level – This is also a blood test done to measure the level of prolactin. If you have a high prolactin level, it can disrupt your ovulation process.
  • Ovarian reserve – This term is used to describe the number of eggs a woman has. A blood test is used to estimate how many eggs you have left in your ovaries.

Depending on your symptoms and the results of your initial tests, you may also undergo imaging tests, including ultrasound or laparoscopy to view the fallopian tubes and ovaries, or sonohysterography, hysterosalpingography or hysteroscopy to view the fallopian tubes and inside the uterus to determine if there are blockages or scarring.

What is Ovulation Induction?

In order for a couple to conceive, an egg has to be released from the woman’s ovaries and fertilized. For about 30 percent of the women who struggle to get pregnant, irregular or lack of ovulation (called anovulation) is the issue. If the culprit behind your inability to become pregnant is a problem with ovulation, your doctor may recommend undergoing ovulation induction.

Ovulation induction uses medication to stimulate ovulation in those women with irregular or absence of ovulation. The goal of the process is to increase your chances of conception, whether through intercourse or fertility treatments. If you have a gynecologic condition (such as PCOS) that inhibits normal ovulation, you will most likely benefit from ovulation induction. In fact, because it is a noninvasive and effective treatment, ovulation induction is typically one of the first avenues of treatment of infertility.

How does Ovulation Induction Work?

Ovulation induction uses hormone-based medication to help balance and regulate your reproductive hormones, which increases your chances of regular ovulation. The most commonly used medications for the treatment include:

  • Clomiphene citrate or aromatase inhibitors – these medications stimulate ovulation in women with normal pituitary gland hormone function, but who are still not ovulating regularly.
  • Gonadotropins – This treatment combines two injectable hormones, luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These two hormones are normally produced by the pituitary gland, and are responsible for encouraging egg development. Use of gonadotropins requires more frequent monitoring, as it offers a powerful boost to ovulation that may result in multiple eggs being released or ovarian hyperstimulation syndrome (OHSS), a condition where the ovaries are overstimulated and become swollen.

In addition, you may find that getting treatment for another condition (such as hypothyroidism, prediabetes or obesity) may regulate your hormones and naturally jump-start the ovulation process. Our doctors may also suggest that you see an infertility specialist, or Reproductive endocrinologist.

If you are struggling to become pregnant and are searching for a doctor who is experienced in infertility and sensitive to what can be a difficult journey, look no further than Southern OBGYN. Our doctors are passionate about women’s reproductive health, and can guide you through the process, educating you and offering effective treatment so that you can grow your family. Call our office today at 337-235-4460 and schedule an appointment.

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