Infertility Assessment - Female

Infertility Treatments - Female

Infertility is a challenge faced by many couples. A woman is considered infertile if she is unable to conceive after a year of regular, unprotected intercourse. Fortunately, infertility is often treatable. The journey to effective treatment begins with identifying the underlying causes. Various fertility tests are available to help diagnose infertility in women.

During your first visit to Ankur IVF Fertility, we will register you and conduct a thorough review of your medical history, including menstrual, coital, medical, and surgical details. We will also examine your previous reports and past treatments. To ensure a comprehensive assessment, we recommend bringing all relevant treatment records and documents with you.

When evaluating infertility, doctors typically begin with a physical examination and a discussion to understand the patient's medical history and lifestyle. Additionally, one or more of the following tests may be recommended:

What is Ovarian Reserve Assessment?

Ovarian reserve testing helps doctors assess a woman's fertility potential. These tests offer insights into the remaining time for conception and the number of eggs at an advanced developmental stage. Simple blood tests, such as AMH, E2, and FSH, are used to measure hormone levels and evaluate the quantity and quality of eggs.

Tests for Ovarian Reserve

Below are some common ovarian reserve tests recommended by doctors:

Anti-Müllerian Hormone (AMH)

Anti-Müllerian Hormone (AMH) is produced by the cells in the follicles, which are the sacs containing eggs in a woman’s ovaries. High AMH levels indicate a larger number of follicles and, consequently, more eggs. As women age, the number of eggs decreases, leading to a decline in AMH levels. This blood test can be performed at any time and provides a reliable estimate of the egg reserve.

Follicle-Stimulating Hormone (FSH)

Follicle-Stimulating Hormone (FSH), produced by the pituitary gland in the brain, plays a key role in maturing eggs within the ovaries. This blood test is typically conducted on the 2nd or 3rd day of the menstrual cycle. Unlike AMH, elevated FSH levels suggest diminished ovarian reserve, while lower FSH levels indicate a healthier ovarian reserve.

Estradiol

Estradiol (E2) is tested alongside FSH and is a crucial form of estrogen that supports the development of healthy eggs in a woman's ovaries. Elevated estradiol levels in the E2 test may signal issues with egg quantity or quality.

Antral Follicle Count (AFC)

Antral Follicle Count (AFC) is considered one of the most reliable indicators of ovarian reserve, as it assesses both the quantity and quality of eggs. Antral follicles, found in the ovaries, contain immature eggs that can develop into mature eggs. A vaginal ultrasound is an effective method for counting these follicles. A high AFC suggests a strong ovarian reserve, while a low AFC indicates reduced fertility potential.

Ovarian reserve testing

Ovarian reserve testing is not a definitive measure of infertility, but significant changes in hormone levels provide valuable information that helps doctors develop an effective treatment plan.

BBT Charting

Doctors often recommend tracking your Basal Body Temperature (BBT) when trying to conceive. A rise in BBT signals ovulation and helps identify the optimal time for intercourse. This tracking can be done easily at home.

Postcoital Test

A couple may be advised to have unprotected intercourse and then visit the doctor a few hours afterward. The doctor will collect a sample of cervical mucus for testing to assess how sperm cells interact with it. This test also helps evaluate sperm motility.

Transvaginal Ultrasound Examination

Unlike a standard external ultrasound, a transvaginal ultrasound involves inserting a specialized device into the vagina. It uses high-frequency sound waves to produce images of the uterus and other reproductive organs on a screen. This allows the doctor to detect any structural issues, such as fibroids, that could affect pregnancy. The procedure is painless and is typically performed about two weeks before the patient’s expected menstrual period.

Hysterosalpinogram

This procedure, also known as a tubogram or HSG (hysterosalpingography), is used to detect blockages in the fallopian tubes and abnormalities in the uterus. It is typically performed between the 6th and 13th day of the menstrual cycle. During the test, a contrast dye is injected into the uterus through the vagina, and a series of X-ray images are taken to track the dye's movement through the fallopian tubes. If there is a blockage, the dye will not pass through.

Hysteroscopy

A hysteroscopy is typically recommended if an obstruction is detected during the hysterosalpingogram, often in conjunction with a laparoscopy. During a hysteroscopy, a thin, flexible telescope-like device is inserted through the vagina into the uterus. This allows doctors to visually examine the interior of the uterus and check for any structural issues. It’s not always necessary to conduct all of the above tests, and in some cases, even after testing, no clear cause of infertility may be found.

Frequently Asked Questions

When Should I Consider IVF?

IVF was initially developed for women with blocked or absent fallopian tubes and remains the preferred treatment in these cases. It is also used for other fertility issues, including endometriosis, male infertility, and unexplained infertility, where no clear medical cause can be identified. Our specialists will assess your medical history and guide you towards the most suitable diagnostic tests and treatment options for your situation.

What Contributes to Male Infertility?

Around one-third of infertility cases are related to male factors, which can also contribute to a higher risk of miscarriage. The most common causes of male infertility include:

  • Abnormal sperm count or low sperm motility
  • Chronic health conditions like cancer
  • Environmental factors such as exposure to harmful chemicals or radiation
  • Lifestyle factors like obesity, smoking, and alcohol consumption
  • Age

What Contributes to Female Infertility?

Infertility affects both men and women equally, with one-third of infertility cases linked to female factors. Globally, 50-80 million people experience infertility. Common causes of female infertility include.

  • Age
  • Endometriosis
  • Hormonal imbalances leading to ovulation issues
  • Blocked fallopian tubes
  • Uterine fibroids
  • Lifestyle factors such as obesity, smoking, alcohol, and poor diet
  • Unexplained infertility

How Does Age Impact a Woman's Fertility?

Women are born with about 2 million eggs in their ovaries. By the time a girl reaches puberty, approximately 11,000 eggs are lost each month. As a result, by the teenage years, a woman has around 300,000 to 400,000 eggs left. From then on, about 1,000 eggs are depleted monthly. This natural decline in egg quantity is unrelated to birth control, pregnancy, hormone levels, health, lifestyle, or supplements. Eventually, a woman reaches menopause when no viable eggs remain.

Does PCOS Affect a Woman's Fertility?

Polycystic Ovarian Syndrome (PCOS) is a hormonal condition where women produce higher levels of male hormones, disrupting normal ovulation and causing irregular menstrual cycles. This hormonal imbalance makes it more difficult for women with PCOS to conceive, making it one of the leading causes of female infertility.