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Basic Work Up of the Infertile Couple

Infertility is often a multifactorial problem and in any given couple may be related to the female partner, the male partner or the combination of both. Here we look at the lab tests, examinations and procedures, which help in diagnosing and predicting the fertility of the couple.

A basic infertility evaluation begins with a thorough medical history of the couple. Both partners are interviewed together, and a physical examination is routinely done.

The workup varies greatly, depending upon the medical history and the ages of the patients involved. In the absence of obvious reasons to do otherwise, the evaluation of infertility proceeds along simple and logical lines of a basic three-step infertility work-up.

	Test for eggs

	Test for sperm

	Test to make sure they can get together

For the male the specific tests required may include:

	A semen analysis

	Blood tests

	Referral to an andrologist if an abnormality is detected.

For the female the specific tests required may include:

	Hormonal tests

	An infectious diseases screen

	Endometrial biopsy

	X-ray to determine patency of the fallopian tubes (hysterosalpingogram)

	Ultrasound, possibly with saline infusion (Saline Infusion Sonography)

	Hysteroscopy, a procedure in which a small telescope is placed in the uterus to check for abnormalities

	Laparoscopy, a surgical procedure in which a small telescope is placed through the navel, to check for abnormalities of the tubes, ovaries and pelvis. This is the only way to diagnose mild forms of endometriosis

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