Evaluation for infertility should be in systematic, expeditious and cost-effective manner identifying all relevant factors. Generally, the initial emphasis is on the least invasive methods for the detection of most common causes. No treatment should be initiated until the baseline tests are performed.
When to evaluate??
- No conception even after trying to conceive for one year
- Early evaluation (after 6 months of trying) is needed when,
- Age over 35 years
- Menstrual abnormalities
- Known/ suspected uterine/ tubal disease
- Partner sub-fertile
Female Factors for Infertility
- Diminished egg reserve
- Uterine factor
- Tubal factor
Evaluation of Ovarian Reserve
It’s a measure of “reproductive potential” that is the number and quality of remaining oocytes(eggs).
Antral Follicle Count (AFC)
Follicles in both the ovaries are counted by trans-vaginal ultrasound.
AMH (Anti-Mullerian Hormone)
It cycles independent “qualitative” & “quantitative” markers of predicting ovarian reserve and response.
Evaluation of Ovulatory Function
|Evaluation of Ovulatory Function||Evaluation of Uterus||Evaluation of Ovulatory Function|
|Menstrual history||Transvaginal Ultrasound (2D/3D)||Hysterosalpingography (HSG)|
|Basal body temperature||Sonohysterography (SHG)||Sonosalpingography (SIS)|
|Urinary LH||Hysterosalpingography (HSG)|
|Serial Transvaginal Ultrasound|
Other Hormonal Tests:
- FSH,LH (D2/3/4)
- Estradiol (D2/3/4)
- Thyroid function tests