During a patient’s first visit to RMA of Philadelphia, both the female and male partners will be evaluated to determine why pregnancy has not yet occurred. Each patient will meet with one of our doctors, who will review the patient’s medical history and perform a comprehensive physical exam. Hormonal evaluation and ultrasound may also be performed. All of this, as well as other information, will be used to develop the right treatment plan, personalized for each patient.
There are several important tests that help us to determine a woman’s reproductive health and fertility.
Typically, a hormonal evaluation will be performed. The specific tests obtained will depend on each woman’s medical history. For example, thyroid hormone levels, or male hormone levels such as testosterone, will be measured, as appropriate. Follicle stimulating hormone (FSH) levels are often measured on the second, third or fourth day of a woman’s menstrual period because it is highly predictive of future fertility. Women in their late 30s and 40s, with an elevated FSH level, typically require the use of donor eggs in order to achieve pregnancy. Younger women with elevated FSH levels may still be able to achieve pregnancy, using her own eggs.
It is also important to examine a woman’s uterus and fallopian tubes prior to starting treatment. A hysterosalpingogram is a type of X-ray test performed to evaluate the fallopian tubes, uterus and surrounding areas. This test allows us to determine if there is an injury to or abnormal structure of the uterus or fallopian tubes, or a blockage that would prevent an egg from moving through a fallopian tube to the uterus. A blockage also could prevent sperm from moving into a fallopian tube and fertilizing an egg.
Hysteroscopy is another test that helps evaluate the inside of the uterus. This is a brief office procedure that allows for direct visualization of the uterine cavity, to determine the presence of polyps, adhesions or fibroids.
It is equally important for the male partner to be evaluated, to determine if there are any problems with sperm production, hormone imbalances or other conditions that may affect fertility. A semen analysis will be done, to test for several factors that can affect fertility, including sperm count, motility (the ability for sperm to move and swim) and morphology (size and shape of the sperm).
Following complete medical evaluations of both the female and male partners, your doctor will discuss the test results, explain the diagnosis and outline treatment options designed to give each patient the best possible chance of having a healthy baby.