What is typically involved in the initial evaluation of a couple’s infertility?

The usual infertility investigation evaluates three main areas. The first is whether the woman is naturally ovulating. This can sometimes be determined by the regularity of her menstrual cycles, other times it is not so obvious. Using hormone testing and ultrasound evaluation, we can determine if ovulation is occurring. The second area of evaluation is that of the female reproductive system. The uterus and ovaries are typically examined by ultrasound to be certain there are no abnormalities. Additionally, a procedure called a hysterosalpingogram (HSG) can be performed to determine whether both the fallopian tubes are open. This is a procedure that is typically done in a radiology setting. It involves placing dye through the patient’s cervix and into the uterine cavity. From there it spreads into the fallopian tubes and is able to be visualized on plain film x-ray. The final piece of the initial infertility evaluation is a semen analysis. The semen parameters of count, movement and shape are determined. After the above diagnostic testing has been completed, you will typically meet again with your physician to review all the studies and put together a treatment plan individualized for you.