What is infertility?
Infertility is defined as the inability to conceive between two partners despite unprotected intercourse for 12 months. 84% of couples will conceive within 12 months, 92% within 2 years.
There is also a difference between those men and women who have previously had children and those who have not. Primary infertility is when an individual has never had a child. Secondary infertility is when an individual has previously had a child. Certain conditions are more likely to cause primary and secondary infertility.
Once a couple has been determined to suffer from infertility an evaluation of both the male and female is indicated. 50% of the time a female factor is identified. 20% only a male factor is identified. And 30% of the time there is an issue with both partners.
The evaluation
The evaluation of women is typically performed by an obstetrician/gynecologist or reproductive endocrinologist. A thorough history of risk factors, such as surgeries, chemical exposures, STDs, will be conducted. Routine bloodwork, including hormone levels, are checked. An examination is also performed. Additional testing, such as an x-ray study to evaluate the female reproductive tract, called a salpingogram, may be performed. The goal is to figure out if there is a hormone issue or physical issue.
Men go through a similar evaluation with interview questions and blood work. The key difference, and most important test for men, is the semen analysis.
Semen analysis
The semen analysis will give you information about the volume, number of sperm, and how normal those sperm look and move.
In general, male infertility falls into one of several groups. Men who have low semen volume, men who have low sperm counts, men who have no sperm, men who have abnormal sperm.
For more information on understanding your semen analysis check out this post.
Treatments
Depending on the type of fertility your physician may make various recommendations. These may range from supplements, to surgeries, assisted reproductive techniques, like IVF, or even adoption.