Basic fertility Evaluation – Female Partner
When a couple visits their fertility doctor (when should a couple visit – please read the blog post ) a basic evaluation is performed or both husband and wife. In this blog post, we will be discussing the evaluation of the female partner.
The first step is HISTORY TAKING, paying extra attention to
1. Menstrual cycles: what was her age when menses started, if they are regular or irregular, how is the bleeding- average, more, less? Are her periods painful, if yes, how painful are they; so on and so forth.
2. Any previous treatment is done, records available.
3. On any current medications
4. Any surgeries in the past, again special attention is given to any surgery involving the ovary, uterus or fallopian tubes.
5. Any pregnancies in the past. If yes, details of those pregnancies.
6. Sudden weight loss, weight gain. On any weight loss/ gain programme.
7. Any medical condition – Thyroid disorder, Prolactin levels
8. History of any genetic abnormality in the immediate family; Consanguineous Marriage;
ü Haemoglobin
ü Complete blood count
ü Sugar levels
ü Urine test
ü Thyroid Hormone Levels
ü Prolactin Hormone Levels
a. OVULATION: Release of an egg, around 14th day of every menstrual cycle.
b. FALLOPIAN TUBES: Open, blocked (at what level are they blocked), swollen (hydrosalpinx- filled with water, pyosalpinx – filed with pus)
c. UTERUS: Fibroids, Adenomyosis, Polyps, any other associated pathology.
d. OVARIES: if any cyst is present, signs of PCOD, any other abnormal findings.
FERTILITY TESTS:
Ovulation can be tested in many ways, most reliable and commonly used is documentation of collapse of developing leading follicle on transvaginal sonography.
Ovulation prediction kits can also be used, they are not very accurate and reliable.
Fallopian Tubes are tested by hysterosalpingography (taking XRay films when dye passes through the tubes). Other better and less painful methods are HY-CO-SY (hystero-contrast sonography) or sonosalpingography.
The uterus is tested by Basic ultrasonographic evaluation of the pelvis is absolutely necessary. Evaluation of the adnexa, tubes, ovaries and uterine muscle and cavity.
Primary fertility evaluation when done in the pre-conception period, female partner is also tested for
1. Blood group and Rh factor
2. If she has immunity against rubella virus
3. Serology for Hepatitis (B and C), HIV and syphilis status.
4. Haemoglobin Electrophoresis to see if she is a carrier for any hemoglobinopathies (beta thalassemia, Alpha thalassemia)
PRIMARY FEMALE EVALUATION IS ALWAYS CYCLICALLY CORRELATED WITH SEMEN ANALYSIS FOR MALE.
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