We trace about 40% of infertility problems to the female partner; another 40% to the male; and the remaining 10% are classified as unexplained. Both partners are evaluated simultaneously, first with a complete history and physical examination and then with the more specific testing appropriate to the complaints presented and referred diagnosis performing to the couple.
Complete couple oriented infertility evaluation
Male evaluation
Male factor problems may be related to:
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 Inadequate or abnormal sperm production and delivery
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 Anatomical problems
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 Previous testicular injuries, or hormonal imbalances
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 Sexual dysfunction and impotence
Our laboratory is fully equipped to perform detailed semen analysis. Non invasive Doppler examination is done to assess the presence of varicocele.
Female factor
Female infertility is primarily due to ovulatory dysfunction, fallopian tube dysfunction, uterine or pelvic pathologies.
Ovulation and connected phenomenon can be detected by Ultrasound Examination including colour doppler study ( this is a clinical tool for imaging the dynamic changes in the ovary and uterine endometrium). Follicular sonography is best performed with vaginal transducer and the follicular details are clearly imaged.
Hysterosalpingogram (HSG)- an x-ray of the uterine cavity and fallopian tubes using a radiographic dye to detect structural abnormalities of the uterine cavity and fallopian tubes. Also Sonosalpingography is done to rule out tubular blocks.
Hysteroscopy- often done in conjunction with laparoscopy or separately visualize the interior of the uterine cavity for scar tissue, adhesions, polyps, tumors, and other abnormalities and to eliminate endometriosis.
Diagnostic laparoscopy- a minimally invasive surgical procedure typically performed as an outpatient day surgery. It permits direct visual assessment of the uterus, fallopian tubes, ovaries, and lower pelvic\s. It is particularly useful in diagnosing endometriosis, tubular disorders, or pelvic adhesions and generally is performed at the end of a work-up, but may be performed earlier if deemed appropriate by the patients history and referral diagnosis.
Hormonal evaluation
Serum hormone testing- measures the levels of luteinizing hormone, follicle stimulating hormone (FSH), prolactin, progesterone, and thyroid stimulating hormone (TSH). Follicle stimulating hormone is produced by the anterior pituitary gland and stimulates the ovary to develop a follicle for ovulation. Progesterone hormone is produced after ovulation has occurred and prepares the uterus for pregnancy.
Luteinizing hormone and follicle stimulating hormone levels are checked for hypothalamic pituitary dysfunction. It should be done on the 2nd day of a naturally occurring periods. Prolactin ( a hormone that stimulates breast milk production) levels are checked to see for it’s excess (hyoperprolactinemia) a condition that interferes with ovulation. Progesterone levels are performed to determine, if inadequate, or levels are interfering with the development of the endometrium, the lining of the uterus that prepares itself for embryo implantation. FSH, T3, T4 is checked to measure thyroid function.