Evaluation of Female Infertility

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An infertility evaluation can be started by whichever doctor you see for pap smears and other female issues. Ultimately, you will probably need a gynecologist or even a specialist in reproductive medicine to thoroughly investigate the possible reasons you are having trouble getting pregnant.

Documentation of ovulation is a key part of an infertility evaluation, and is the one thing you may already know when you get to the doctor. You may know that you ovulate, or you may not have been able to detect ovulation.

The first thing a doctor will do is take a thorough history. If you are being evaluated for infertility, you may want to talk to your doctor without your partner present. There may be things you do not want to talk about in front of him. The doctor will want to make sure that you are having regular intercourse, especially in the middle of your cycle, and that you are not using anything like lubricant that might make it harder to get pregnant.

He or she will ask about your menstrual history. The doctor will also want to know if you have ever been pregnant. If so, did you have the same partner you do now? Did you have a baby, or was your pregnancy terminated spontaneously or by choice? While these may be difficult questions, it is essential that you answer the doctor honestly.

The first thing to establish is whether or not you are ovulating. If you have regular menstrual cycles between 22 days and 35 days, you probably ovulate. If you have pain in the middle of your cycle, you may be having ovulatory pain, called mittelschmerz. Also, if you have premenstrual symptoms, you probably ovulate, since progesterone contributes significantly to those symptoms.

You may already have checked to see if you ovulate. One way of doing this is by measuring basal body temperature, your temperature first thing in the morning. Your temperature may increase from the range of 97 to 98 degrees F to greater than 98 degrees, with the peak being two days after the LH surge that causes ovulation. This temperature increase provides evidence of ovulation.

{ MORE: What Infertility Really Felt Like }

Most people now use an over-the-counter fertility test instead. These tests measure the spike of LH in your urine. This high level occurs 14 to 48 hours before you ovulate. A measurable LH spike found by one of the tests proves that you are having an ovulatory cycle. This is also useful when you are trying to get pregnant because the test is positive before you ovulate, telling you that it is the best time to try and conceive. The LH level may be the best test to confirm ovulation.

If you have not done either of these things, the doctor may suggest the LH tests and/or a blood test to check the levels of progesterone in the second half of your cycle, between when ovulation is expected and the start of your next period. An appropriately-high progesterone level means that the follicle in your ovary is now producing progesterone in preparation for a pregnancy.

{ MORE: Should You Freeze Your Eggs? 7 Facts to Consider }

Documentation of ovulation is a key part of an infertility evaluation, and is the one thing you may already know when you get to the doctor. You may know that you ovulate, or you may not have been able to detect ovulation.

If you arrive at the doctor’s office with information indicating that you are not ovulating, the doctor will try and discover why. If you have been ovulating, there will be a different focus. Either way, the doctor will go over your medical history as well as do a number of tests.

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27 comments

  1. Avatar of shaunda shaunda says:

    I currenting think i have this problem.

  2. Avatar of joyce joyce says:

    I couldn’t imagine having to go through this. it would be devastating to me.

  3. Avatar of EbyMom EbyMom says:

    If you find your self in this situation hope in God as you undergo medical examination. It could happen to anybody.both patners must stand with eachother in this process.Nothing is too hard for our God. It is well.

  4. Avatar of Toshi89 Toshi89 says:

    C sections usually don’t keep u from getting pregnant but they can keep you from having natural birtg

  5. Avatar of Marilyn Marilyn says:

    This is sad. I feel bad for these people.

  6. Avatar of monette3 monette3 says:

    My heart breaks for all who suffer with this! I’m glad that advances in medicine make it possible to seek help with this.

  7. Avatar of Melissa Melissa says:

    It’s sad how so many deserving woman cannot conceive. My heart goes out to you :/ may God bless you with joyful news soon

  8. Avatar of Lulu Lulu says:

    Some very true and excellent tips.

  9. Avatar of DREA DREA says:

    I am a victim of crime and was told for several years by my Dr.’s i would never be able to get pregnant . After trying for so many years and no results i gave up and told myself i guess there is no hope and that i was just unable to conceive. Well , i must say here i am 16 weeks pregnant and me and my baby are as healthy as and ox . I wanted to write this comment to tell ladies out there to never stop having hope like i did . Stay strong and it will eventually happen if God say’s its meant to be . Best wishes and Happy pregnancy to all !!! :D

  10. Avatar of DANIYAH DANIYAH says:

    i wish they find a cure for woman to be able to have kids without having to go thru all of this

  11. Avatar of Verucap Verucap says:

    I’m very glad I haven’t had to deal with infertility. My heart goes out to those who have, though.

  12. Avatar of Julie Julie says:

    We thought that I may not have been fertile, turns out my uterus was a little tilted. We didn’t find that out until after I got pregnant though.

  13. Avatar of sukismom sukismom says:

    I hope my previous c-section doesn’t give me problems in the future!

  14. Avatar of Nella3137 Nella3137 says:

    Great and useable info

  15. Avatar of Frederick Frederick says:

    thumbs up on the info

  16. Avatar of evelyn evelyn says:

    didn’t know people went through this

  17. Avatar of NiñaSolano NiñaSolano says:

    wow! this process is incredible…

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