How is it Diagnosed?
Infertility is diagnosed when a couple fails to conceive after one year of regular,
unprotected intercourse (or six months if the woman is over 35). Diagnosis involves
both partners and includes a combination of medical history, physical examination,
laboratory tests, and imaging.
For women, the evaluation begins with a detailed menstrual and reproductive history.
Hormonal assays are conducted to assess ovulatory function, including Follicle
Stimulating Hormone (FSH), Luteinizing Hormone (LH), thyroid hormones (TSH),
prolactin, and estradiol levels. Mid-luteal phase serum progesterone may confirm
ovulation.
Imaging studies such as transvaginal ultrasound are used to evaluate ovarian reserve,
uterine anatomy, and endometrial lining. Antral follicle count and Anti-Müllerian
Hormone (AMH) levels help determine ovarian reserve.
To assess fallopian tube patency, a hysterosalpingogram (HSG) or sonohysterography
is conducted. In some cases, hysteroscopy or laparoscopy may be indicated to
diagnose endometriosis or pelvic adhesions.
For men, a semen analysis is the cornerstone diagnostic test, evaluating sperm count,
motility, and morphology. If abnormalities are found, further tests such as scrotal
ultrasound, hormonal assays (testosterone, FSH, LH), and genetic testing may be
performed.
Psychosocial and lifestyle factors, including stress, smoking, obesity, and occupational
exposures, are also assessed.
A collaborative approach involving gynecologists, urologists, and fertility specialists
helps in determining the exact cause and deciding appropriate treatment.