Infertility: When to Seek Help and What Tests to Consider

Want to conceive?

Doctor, how long of normal sexual activity without pregnancy is considered infertility? What tests should be done? I have had a bacterial infection in the past; will taking medication for a period of time affect fertility? Please help answer these questions.
Thank you!

Xiao Fang, 30~39 year old female. Ask Date: 2001/03/04

Dr. Zhan Deqin reply Obstetrics and Gynecology

1.
Infertility is defined as the inability to conceive after one year of regular unprotected intercourse.
2.
There are many tests to be conducted, and the doctor will determine the necessary examinations based on your situation.
3.
Mild infections are usually not a concern, but severe infections or chronic infections can lead to blocked or adhesed fallopian tubes, affecting fertility.
If you have any issues, please visit a gynecology clinic for an evaluation.

Reply Date: 2001/03/04

More Info

Infertility is a complex issue that affects many couples, and understanding when to seek help and what tests to consider is crucial for addressing this challenge. In general, infertility is defined as the inability to conceive after one year of regular, unprotected intercourse for women under 35 years old. For women aged 35 and older, this timeframe is reduced to six months. If you find yourself in this situation, it is advisable to consult a healthcare provider specializing in reproductive health.

When you decide to seek help, the first step typically involves a comprehensive evaluation of both partners. This may include a detailed medical history, physical examinations, and specific tests to identify potential causes of infertility. Common tests for women include:
1. Ovulation Testing: This can be done through blood tests to measure hormone levels or through ovulation predictor kits that detect the surge in luteinizing hormone (LH) that occurs before ovulation.

2. Hysterosalpingography (HSG): This X-ray procedure involves injecting a dye into the uterus and fallopian tubes to check for blockages or abnormalities.

3. Transvaginal Ultrasound: This imaging test allows doctors to visualize the ovaries and uterus to identify any structural issues, such as cysts or fibroids.

4. Blood Tests: These can assess hormone levels, including thyroid hormones and prolactin, which can affect fertility.

5. Laparoscopy: In some cases, a minimally invasive surgical procedure may be performed to look for endometriosis or other pelvic issues.

For men, the evaluation typically includes:
1. Semen Analysis: This test assesses the quantity and quality of sperm, including motility and morphology.

2. Hormonal Testing: Blood tests can evaluate testosterone and other hormones that influence sperm production.

3. Genetic Testing: In certain cases, genetic factors may be evaluated to determine if they contribute to infertility.

Regarding your concern about past bacterial infections and medication use, it is essential to discuss these factors with your healthcare provider. Some infections can lead to scarring or blockages in the reproductive tract, which may impact fertility. Additionally, certain medications can affect hormone levels or ovulation, so it is crucial to provide your doctor with a complete list of any medications you have taken.

If you have been trying to conceive for an extended period without success, it is important to remember that infertility is not solely a female issue; male factors contribute to about 30-40% of infertility cases. Therefore, both partners should be evaluated to identify any underlying issues.

In summary, if you have been actively trying to conceive for a year (or six months if over 35), it is advisable to seek help from a fertility specialist. They can guide you through the necessary tests and help develop a tailored treatment plan based on the findings. Remember, infertility can be a challenging journey, but with the right support and medical guidance, many couples can achieve their goal of parenthood.

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