Infertility – Diagnosis and treatment – Mayo Clinic

Diagnosis

Before infertility testing, your doctor or clinic works to understand your sexual habits and may make recommendations to improve your chances of getting pregnant. In some infertile couples, no specific cause is found (unexplained infertility).

Infertility evaluation can be expensive, and sometimes involves uncomfortable procedures. Some medical plans may not cover the cost of fertility treatment. Finally, there's no guarantee even after all the testing and counseling that you'll get pregnant.

Male fertility requires that the testicles produce enough healthy sperm, and that the sperm is ejaculated effectively into the vagina and travels to the egg. Tests for male infertility attempt to determine whether any of these processes are impaired.

You may have a general physical exam, including examination of your genitals. Specific fertility tests may include:

Blocked fallopian tubes or an abnormal uterine cavity may cause infertility.

Hysterosalpingography, or HSG, is an X-ray test to outline the internal shape of the uterus and show whether the fallopian tubes are blocked.

In HSG, a thin tube is threaded through the vagina and cervix. A substance known as contrast material is injected into the uterus.

A series of X-rays, or fluoroscopy, follows the dye, which appears white on X-ray, as it moves into the uterus and then into the tubes. If there is an abnormality in the shape of the uterus, it will be outlined.

If the tube is open, the dye gradually fills it. The dye spills into the pelvic cavity, where the body resorbs it.

Fertility for women relies on the ovaries releasing healthy eggs. The reproductive tract must allow an egg to pass into the fallopian tubes and join with sperm for fertilization. The fertilized egg must travel to the uterus and implant in the lining. Tests for female infertility try to find out if any of these processes are impaired.

You may have a general physical exam, including a regular gynecological exam. Specific fertility tests may include:

Depending on your situation, rarely your testing may include:

Not everyone needs to have all, or even many, of these tests before the cause of infertility is found. You and your doctor will decide which tests you will have and when.

Infertility treatment depends on:

Some causes of infertility can't be corrected.

In cases where spontaneous pregnancy doesn't happen, couples can often still achieve a pregnancy through use of assisted reproductive technology. Infertility treatment may involve significant financial, physical, psychological and time commitments.

Men's treatment for general sexual problems or lack of healthy sperm may include:

Some women need only one or two therapies to improve fertility. Other women may need several different types of treatment to achieve pregnancy.

Assisted reproductive technology (ART) is any fertility treatment in which the egg and sperm are handled. There are several types of ART.

In vitro fertilization (IVF) is the most common ART technique. IVF involves stimulating and retrieving multiple mature eggs, fertilizing them with sperm in a dish in a lab, and implanting the embryos in the uterus several days after fertilization.

Other techniques are sometimes used in an IVF cycle, such as:

Complications of infertility treatment may include:

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Coping with infertility can be extremely difficult because there are so many unknowns. The journey can take an emotional toll on a couple. Taking these steps can help you cope:

Try these strategies to help manage emotional stress during treatment:

You'll face the possibility of psychological challenges no matter your results:

Seek professional help if the emotional impact of the outcome of your fertility treatments becomes too heavy for you or your partner.

Depending on your age and personal health history, your doctor may recommend a medical evaluation. A gynecologist, urologist or family doctor can help determine whether there's a problem that requires a specialist or clinic that treats infertility problems. In some cases, both you and your partner may require a comprehensive infertility evaluation.

To get ready for your first appointment:

For infertility, some basic questions to ask your doctor include:

Don't hesitate to ask your doctor to repeat information or to ask follow-up questions.

Be ready to answer questions to help your doctor quickly determine next steps in making a diagnosis and starting care.

Possible questions for couples include:

Your doctors may ask:

Your doctors may ask:

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Infertility - Diagnosis and treatment - Mayo Clinic

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