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Understanding Infertility -- Treatment

How Do I Know If I Am Infertile?

If you are infertile, your doctor will go over your health history, medications, sexual history, and your sex habits, like how often you have sex. 

Men will get a physical exam and often a sperm analysis, which tests the health of his sperm.

Fertility Testing

Q. What goes into a fertility evaluation?
A. A standard fertility evaluation includes physical exams and medical and sexual histories of both partners. Men undergo a semen analysis that evaluates sperm count and sperm movement. "We look at the percent that are moving and how they are moving--are the sperm sluggish? Are they wandering?" says Robert G. Brzyski, M.D., Ph.D., associate professor of obstetrics and gynecology at the University of Texas Health Science Center at San Antonio. "Often, it's not possible to identify a specific reason for a sperm disorder," he says. "But there is new recognition that very low sperm or no sperm may be related to genetics--an abnormality of the Y chromosome."

For women, doctors first check to see whether ovulation is occurring. This can be determined and monitored through blood tests that detect hormones, ultrasound examinations of the ovaries, or an ovulation home test kit. "An irregular menstrual pattern would make us suspicious of an ovulation problem, but it's also possible for a woman with regular periods to have an ovulation disorder," Brzyski says.

For women, testing begins with a medical history and physical exam, including a pelvic exam. The doctor then makes sure that she ovulates regularly and her ovaries are releasing the eggs. Blood tests are taken to measure hormone levels. The ovaries and uterus may be examined by ultrasound, and a specific X-ray test can check the uterus and fallopian tubes. 

In about 80% of couples, the cause of infertility is either an ovulation problem, blockage of the fallopian tubes, or a sperm problem. In 5%-15% of couples, all tests are normal, and the cause is not known.

 

What Are the Treatments for Infertility?

In men, fertility is treated with:

  • Surgery, if the cause is a varicoele (widening of the veins in the scrotum) or a blockage in the vas deferens, tubes that carry sperm.
  • Antibiotics to treat infections in the reproductive organs.
  • Medications and counseling to treat problems with erections or ejaculation.
  • Hormone treatments if the problem is a low or high level of certain hormones.

In women, infertility is treated with:

  • Fertility drugs and hormones to help the woman ovulate or restore levels of hormones
  • Surgery to remove tissue that is blocking fertility (such as endometriosis) or to open blocked fallopian tubes

Infertility in men and woman can also be treated with assisted reproductive technology, or ART. There are several types of ART:

  • IUI (intrauterine insemination): Sperm is collected and the placed directly inside the woman's uterus while she is ovulating.
  • IVF (in vitro fertilization): The sperm and egg are collected and brought together in a lab. The fertilized egg grows for 3 to 5 days days. Then the embryo is placed in the woman's uterus.
  • GIFT (gamete intrafallopian transfer) and ZIFT (zygote intrafallopian transfer): The sperm and egg are collected, brought together in a lab, and quickly placed in a fallopian tube. With GIFT, the sperm and eggs into the fallopian tube. With ZIFT, a fertilized egg is placed into the tube at 24 hours.

 

WebMD Medical Reference

Reviewed by Nivin Todd, MD, FACOG on March 11, 2014
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