Medical Questions & Answers

Question: How do doctors investigate couples who are infertile?
Doctors start their investigations by checking the couple’s sexual habits. A woman is only fertile for four to six days a month, and if sex is infrequent, it is quite easy to miss these days. The first step in specific testing is a sperm analysis in the man. The sperm from an ejaculation is collected in a sterile container and must be examined in a laboratory within two hours. The number of sperm, their shape and their activity are all checked to ensure that they are adequate to fertilize the woman’s egg. If these tests are normal, it is not usually necessary to perform any further tests on the man.
In a woman, the first step is a temperature chart. This involves marking on a graph the woman’s temperature immediately upon waking every morning, the days of the period or other bleeding, and the days when intercourse has occurred. From this and a blood test, a doctor can often see problems with ovulation. There is normally a rise in temperature for the second half of the cycle after the egg has been released from the ovary.
After these simple tests, investigations become more complex. It is necessary to exclude any blockage in the tubes leading from the ovary to the womb, and to assess the woman’s hormonal and biochemical function by a series of blood tests. A careful gynecological examination is performed, and this may be followed by special X-rays or ultrasound scans that outline the uterus (womb) and tubes. The final stage of investigation is an operation called a laparoscopy, in which a small tube is poked through a cut in the lower part of the abdomen. To prevent scarring, the navel is often used for this purpose. Through this tube the doctor can directly examine the female reproductive organs to detect any problems.
Please be assured that although these investigations may not sound very nice, you should suffer no more than discomfort and some indignity, as appropriate anesthetics are given for the more invasive procedures.

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