Infertility

Alternative names:

barren; inability to conceive; unable to get pregnant

Symptoms:

• inability to become pregnant
• a range of emotional reactions by either or both members of the couple related to childlessness (In general, reactions are greater among childless couples. Having a single child blunts the depth of emotion problems).

Signs and tests:

A complete history and physical examination of both partners is essential.

Tests may include:

• semen analysis to evaluate ejaculate; collected after 2 to 3 days of complete abstinence to determine volume and viscosity of semen and sperm count, motility, swimming speed, and shape.
• measuring basal body temperature--taking the woman's temperature each morning before arising in an effort to note the 0.4 to 1.0 degree Fahrenheit temperature increase associated with presumptive ovulation.
• monitoring cervical mucus changes throughout the menstrual cycle to note the wet, stretchy and slippery mucus associated with the ovulatory phase.
• postcoital test (PCT)--to evaluate sperm-cervical mucus interaction through analysis of cervical mucus collected 2 to 8 hours after the couple has intercourse.
• measuring serum progesterone (blood test)
• endometrial biopsy
• testicular biopsy (rarely done)
• measuring urinary luteinizing hormone by using kits commercially available for home use to predict ovulation and assist with timing of intercourse.
• progestin challenge--with sporadic or absent ovulation
• serum hormonal levels (blood tests) for either or both partners
• hysterosalpingography (HSG)--X-ray procedure done with contrast dye that enables evaluation of potential transport from the cervix through the uterus and Fallopian tubes.
• laparoscopy to allow direct visualization.
• pelvic exam (women) to determine if there are cysts or damage to the endometrium.