What happens?
‘Doctor T. Tube’, the infertility specialist, may see a couple like ‘Mandy’ and ‘Andy’, who say they have been trying to conceive for two years without success. Dr Tube would take a thorough history from Mandy and Andy regarding their general health, as there are some diseases which can affect fertility. Dr Tube would specifically enquire about Mandy’s menstrual pattern, and the
couple’s sexual pattern, and examine them both to exclude any obvious physical problems, and test for infections.
A few laboratory tests would be ordered, for example testing the levels of certain hormones in the blood at a particular time in Mandy’s cycle. This will help to show if Mandy is ovulating (producing eggs). Other physical signs of ovulation may be recognized if Mandy wishes to check for them herself over a few cycles. Regular periods, with period pain and premenstrual symptoms are suggestive of ovulation. The body temperature is slightly increased after ovulation. Mandy could take her temperature and record it first thing every day and see if the readings rose after about the middle of her cycle. The other change she might notice is that her vaginal secretions change from watery (before ovulation), to sticky and gluggy (after ovulation). Neither temperature nor mucus changes are extremely reliable. They can suggest an ovulatory pattern, but there are much more specific tests available now.
A sample of Andy’s sperm would be analysed to make sure there were enough healthy sperm swimming around. A post-coital test may be recommended. This test (which sounds more like some rating score from a women’s magazine) involves sampling and examining sperm and the mucus from the vagina within a few hours of intercourse. (Intercourse is often referred to by doctors as coitus.) This test is to look for incompatibility between the sperm and the mucus which is produced by the cervix.
Other hormone tests and chromosome tests on both partners are occasionally performed.
Mandy will probably have a laparoscopy (see appendix 1) to examine her pelvic organs, in particular checking for blockage of her fallopian tubes using a special dye test. X-rays outlining the uterus and tubes (hysterosalpingograms) were done more often in the past, but now laparoscopy seems to be the test of choice, because the doctor can find out so much more from it.
All of these tests have the same goal; finding out the site of the problem, so that, if possible, something can be done about it.
The investigation and treatment of infertility should also include counselling from people experienced in the field. This gives an opportunity for a couple to discuss in more depth their expectations and concerns, and provides the couple with more information and assistance if it is required.
*174\52\4*
