Workup for Female Infertility

workup-for-female-infertility

Workup for Female Infertility

Female infertility is a disorder in which a woman is unable to conceive naturally owing to underlying health issues. Infertility is defined as a woman’s inability to conceive naturally after a year or more of trying.

Everything You Need to Know About Workup for Female Infertility

Female Infertility | Steps | Expect From Doctor | Result | Conclusion

What is Female Infertility?

Infertility in women can be caused by various factors such as insulin resistance, obesity, PCOD/PCOS, endometriosis, and so on. Workup tests performed by a fertility expert determine the specific cause of female infertility.

These tests will involve a medical history questionnaire, a physical examination, and various function testing, among other things. In addition, these tests will rule out the possibility of underlying disease causing infertility.

Steps of Infertility workup for a female

Female infertility is a disorder in which a woman cannot conceive naturally due to underlying health issues. Infertility is defined as a woman’s inability to conceive naturally after a year or more of trying.

The relevance of a fertility workup has increased in recent years. A fertility workup is an infertility examination that involves specific tests that provide information about a woman’s or man’s health.

When a couple has been trying to have a child for a long time but hasn’t been successful, they may need an infertility workup. It is claimed that if a couple fails to conceive regularly, they may have reproductive difficulties.

If the girl is above 35 years old, she should have this examination done right away or within six months. This will reveal the specific infertility issue impacting the pair and generating issues.

A female’s infertility workup consists of the following steps:

Three key stages, such as medical history and physical examination, are crucial components of an initial infertility workup.

Steps 1: Medical History

  • Infertility lasts for a long time.
  • Regularity and flow of menstrual periods.
  • It’s crucial to know about any past pregnancies, deliveries, or losses.
  • It’s crucial to have had bad pregnancies in the past.
  • Endometriosis, cyst surgery, pelvic infections, TB, and other previous operations or diseases are important facts to know.
  • If you have a medical condition such as thyroid disease, diabetes, or hypertension, you should be evaluated.
  • Any hereditary diseases in the family, such as cystic fibrosis or thalassemia, must be disclosed.
  • Intercourse frequency and any difficulties.
  • Use of alcohol, tobacco, or any other substances is prohibited.

Steps 2: Physical Examination

A physical examination is performed to look for any physical signs that might indicate a problem with fertility. Your doctor will evaluate a variety of items during your physical examination, including:

  • A vaginal or pelvic examination will be performed by your doctor to check the cervix and search for any sores, discharge, or infections.
  • Hair growth on the face and body: unusual hair growth on the face and body might suggest an overabundance of male hormones in the body, which can lead to reproductive issues.
  • Breast Exam: Your doctor may check the shape and size of your breasts as well. He may do further tests to rule out specific possibilities.
  • Other tests: A thorough physical examination is performed, with specific attention paid to weight (BMI), pulse, blood pressure, thyroid, and indications of androgen excess such as hirsutism, acne, and Pap smear, among other things.

Steps 3: Investigation

Laboratory and imaging tests are used in infertility workups and provide the foundation for determining the reason for infertility. The female partner’s examinations will focus on ovarian reserve, ovulatory function, and anatomical anomalies. These tests will yield various findings and suggest various things, such as:

Ovarian Reserve

The number of useful eggs in the ovaries that can fertilize is known as Ovarian Reserve. This test is performed using a blood test known as the Anti-Mullerian Hormone. A transvaginal scan is also performed to determine the Antral follicular count. Following the outcome, the Ovarian Reserve has been established.

  • AMH concentration is less than 1 ng/ml.
  • In both ovaries, the antral follicle count is low, with less than 5–7 (follicles 2–10 mm).
  • Follicle-stimulating hormone (FSH) levels are over 10 IU/L.
  • A history of unsatisfactory In Vitro Fertilization stimulation results, with fewer than four oocytes at the time of egg retrieval.

Ovulatory Dysfunction

Ovulatory dysfunction is a term used to describe a substantial number of female infertility cases in which the woman’s ovulation is disrupted or absent. Various experiments are carried out to investigate this issue:

  • Serum progesterone is measured at the mid-luteal stage (day 21).
  • Follicular monitoring and ovulation studies: To identify the development of follicles and their release, sequential ultrasounds are used.
  • Ovulatory dysfunction can be caused by thyroid illness and hyperprolactinemia, thus Thyroid-stimulating hormone and serum prolactin levels are also measured.

Tubal Factor

An evaluation of the tubal factor determines if the fallopian tubes are open or obstructed. This is accomplished by:

  • Hysterosalpingography (HSG) is a technique that involves injecting radiopaque dye contrast into the cervix and seeing the uterus and fallopian tubes. With this process, we can determine if tubes are open or obstructed.
  • Sonosalpingography is the ultrasonographic imaging of the uterus and adnexa with a transcervical canal fluid infusion.

The Uterine Factor

Endometrial polyps, uterine adhesions, uterine abnormalities, and fibroids are among uterine conditions that can cause infertility. These uterine issues make it difficult to conceive. These problems are identified by:

  • Transvaginal ultrasonography can identify fibroids and their size, quantity, and location. Using three-dimensional ultrasonography, müllerian anomalies (abnormalities in the shape of the uterus) and cavity distorting fibroids may be seen more easily.
  • Sonohysterography: The uterine cavity is well-defined, and abnormalities such as endometrial polyps, submucosal fibroids, and intrauterine adhesions are seen with Sonohysterography.
  • Endometrial polyps, uterine synechiae, and submucosal fibroids can all be diagnosed via hysteroscopy, allowing the uterus cavity’s direct sight. Because of its cost and accessibility issues, hysteroscopy is not often utilized for the first assessment of infertile women. Hysteroscopy is used to confirm and treat intracavitary lesions that other imaging methods have identified.

The use of three-dimensional ultrasonography and magnetic resonance imaging can help to define müllerian abnormalities more precisely.

Other Types of Investigation

The doctor may request specialist testing in particular circumstances, such as:

  • Genetic testing and karyotyping
  • Antiphospholipid Antibody 
  • Testing for thrombophilia

12+ Years of Experience as
Sexologist and Infertility Specialist

12+ Years of Experience as
Sexologist and Infertility Specialist

What should I expect when I visit my doctor?

You should be prepared to answer a lot of questions. It all starts with a little Q&A with your doctor to obtain the whole picture of why you’re having difficulties conceiving. Some of the subjects that may be discussed include:

1. History of menstruation
2. Previous pregnancies
3. History of birth control
4. STDs have a long and illustrious history (sexually transmitted diseases)
5. Sexual habits at the moment
6. Medications
7. Surgical background
9. Other serious health concerns
10. Lifestyle
11. Working conditions

Work up for Female infertility Result

Your doctor will be able to tell you the specific infertility problem you or your spouse has after the physical examination and other investigation procedures. Your doctor will be able to recommend the best therapy for your infertility problem after it has been detected. The reason for infertility cannot be determined in 20% of instances, which is referred to as unexplained infertility.

Conclusion

Because of our tireless efforts, we’ve made scientific breakthroughs and technologies that are now available to our patients sooner rather than later. A large number of our patients benefit from new treatments, cutting-edge technology, and clinical research studies before the rest of the world. Make an appointment with our experts and their teams by contacting us. Alternatively, you may send us an email to learn more about the treatments.

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Dr. Ramit Kamate is a Reproductive Medicine Consultant and Sexologist with experience of 12+ years. He specialises in Sexual Medicine for male and female, Fertility Treatment, Pre and Post Delivery Care, Normal Vaginal Delivery (NVD), Tubectomy/Tubal Ligation, Natural Cycle IVF, MTP.

Dr. Ramit Kamate finished MBBS from B J Medical College, Pune. He pursued Masters’s In Reproductive Medicine from Hamilton University, UK & IBCME Dubai. Completed Fellowship in Cosmetic Gynaecology and Sexual Medicine from USA.

Workup for Female Infertility

by | Oct 12, 2021

Workup for Female Infertility

by | Oct 12, 2021

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