A fertility assessment, also called fertility evaluation, is a medical consultation recommended for those couples that have frequent sexual intercourse without using any contraception and have not achieved pregnancy.
Fertility problems are more common than people think. In fact, it is estimated that between 15% and 17% of the couples have fertility problems and the percentage increases each year.
It is important to know that even when the couple has problems to achieve pregnancy in a natural way, it doesn't mean that one or both of them are infertile. Thus, it is important to look for a professional advice.
WHEN IS IT RECOMMENDED TO LOOK FOR A FERTILITY ASSESSMENT?
A couple may visit a fertility specialist since the first moment they decide to have a baby. But, in general terms, experts agree that a couple must look for a professional advice when for more than a year the couple has a constant sexual intercourse without using neither natural or artificial contraception methods and have not achieved pregnancy.
However, in patients with certain conditions that predispose to infertility, experts recommend going to a fertility assessment after 6 months instead of waiting for a year. Among these conditions, women older than 35 years, morphologic alterations in the genitourinary system, traumas or previous surgeries in the genitourinary system and previous sexually transmitted diseases (STD) can be included.
WHAT DOES A FERTILITY ASSESSMENT INCLUDE?
In general terms, a fertility assessment includes examination of the medical and sexual histories of each member of the couple and their physical evaluation. The examination of the medical abd sexual history includes evaluation of previous and current diseases and surgeries, allergies, current medications, the number of sexual partners, the previous and current use of contraception, the antecedent of STDs, etc.
However, it is very important to know that for men and women fertility evaluation tests vary due to the big differences of the genitourinary organs and their functions in each gender.
WHAT PROCEDURES ARE PERFORMED DURING AN ASSESSMENT OF MALE FERTILITY?
The assessment of male fertility is usually easier to perform than the female fertility assessment. So, many experts recommend studying the man in the first place.
The first test to realize in men is a semen analysis, which evaluates the sperm count, its movement and structure, the volume of the ejaculation and the sperm pH (please follow the link to read more on FISH sperm test).
This test is very important because to achieve a natural pregnancy, the spermatozoids must be able to travel in the woman uterus and penetrate the ovum. Likewise, a good number of spermatozoids increases the probability of pregnancy.
Likewise, any structural abnormality in the male genitourinary system can cause infertility. These problems are usually detected with a sperm sample, but some fertility experts recommend performing an imaging test (like an echo-sonogram) if the patient has at least a risk factor for having structural abnormalities.
WHAT PROCEDURES ARE PERFORMED DURING A FEMALE FERTILITY ASSESSMENT?
The female fertility assessment is usually more complicated than the study on men due to the complexity of the female reproductive system. In fact, a female fertility assessment includes from blood tests to invasive examinations of the uterus and Fallopian tubes.
The fertility experts recommend starting with blood tests to measure the hormones levels and to detect the precise moment when ovulation occurs, which is the ideal moment to naturally achieve pregnancy.
However, the moment when ovulation occurs can also be detected through the ultrasound study of the ovaries or even an ovulation-home test kit that is usually available at any pharmacy.
Studying the menstrual cycle of the woman is also important because an irregular menstrual pattern can suggest an ovulation problem. Likewise, the abdominal and intravaginal ultrasounds are the first indicated image tests. An ultrasound allows to determine the external conditions of the female reproductive structure.
When ovulation and extern female reproductive structures are considered normal, the fertility specialists indicate another test called hysterosalpingogram, which is a more invasive procedure in which some X-ray of the fallopian tubes and uterus are taken while a radiographic dye solution is placed into the uterine cavity.
This test has the objective of determining if the uterus and Fallopian tubes are properly open or not. When they are blocked, the dye will be retained in the location of the blockage and it will indicate the incapability of the sperm to properly reach the ovum.
WHAT CAN A FERTILITY ASSESSMENT REVEAL?
In most cases, neither a man nor a woman has an identifiable cause of infertility, and it is called idiopathic infertility, which means of unknown cause. However, in other cases, the fertility specialist can detect the infertility cause.
In both cases, the specialist can determine a way of treatment and the couple usually achieves a successful pregnancy in a few months.
HOW MUCH DOES FERTILITY ASSESSMENT COST?
The cost of fertility assessment can widely vary according to the couple needs, diseases and medical history.