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Hormones are the signaling molecules that bring about various events like egg development and release, development of uterine lining to support an early embryo and menstruation in a woman in a precise and highly regulated manner. Any disruption, even minor, in this pathway leads to fertility problems. Similarly, in men hormonal imbalances may lead to problems with achieving erection and ejaculation, and may deteriorate semen parameters. Hence, hormonal evaluation of both partners is an important step in fertility work up.
The evaluation is performed to detect the causes of infertility in both males and females. The causes may include medical history of one of the partners or both, physical examination, assessment of female reproductive tract, endometrial layer and abdominal cavity.
Following are the evaluation performed for male fertility:
Semen Analysis: In this method, semen is collected and sent to a laboratory to measure the sperm count present and look for any abnormalities in the shape and motility of the sperm.
Scrotal Ultrasound: Scrotal ultrasound is used to see the problems in the testicles.
Hormone Testing: A blood test is done to measure the testosterone and other hormone levels.
Post- ejaculation Urinalysis: Sperm in urine indicates that patient’s sperm is travelling into the bladder instead out of the penis during ejaculation.
Genetic Tests: Certain blood tests are done to reveal the genetic abnormality. Genetic testing might be ordered to diagnose various congenital or inherited syndromes.
Biopsy of Testicles: This test includes removing samples of the testicles in order to check the whether sperm production is normal.
Specialized sperm function tests: A number of tests can be used to check how well sperm survive after ejaculation, how well they can penetrate an egg and whether there’s any problem attaching to the egg. However, these tests are rarely performed.
Transrectal Ultrasound: In this procedure a small lubricated wand is inserted into the rectum which allows the doctor to check prostrate and blockages of the tube that carries the semen.
Female fertility evaluation includes:
Ovulation testing: This test is used to detect LH level that occurs before ovulation. It is done by a blood test to check the progesterone and other hormone levels such as prolactin.
Hysterosalpingography: In this procedure, X-ray contract is injected into your uterus and an X-ray is taken to detect abnormalities in the uerine cavity. This test also determines whether the fluid passes out of the uterus and spills out in the fallopian tubes. If such abnormalities are found then it is likely that the patient is sent for further evaluation procedures.
Ovarian reserve testing: This test is done to determine the quantity of eggs available for ovulation.
Imaging tests: It is an ultrasound which is used to look for the abnormalities in uterine and fallopian tube.
Other hormone testing: this test checks the levels of ovulatory hormones as well as thyroid and pituitary hormones that control reproductive process.