Are You Infertile?

Everyone starts with the same dream of a family…Meeting someone special, falling in love and when the time is right starting to have children. It can be devastating when you come to find this dream is not easy to make a reality. For most couples not using contraception, pregnancy should be achieved within a year. If this has not happened you may need to seek help from a physician. If the female partner is over 35 you may also consider seeking help after 6 months of trying to conceive.

Posted on | Anitha Nair, MD | Comments ()

Everyone starts with the same dream of a family…Meeting someone special, falling in love and when the time is right starting to have children. It can be devastating when you come to find this dream is not easy to make a reality. For most couples not using contraception, pregnancy should be achieved within a year. If this has not happened you may need to seek help from a physician. If the female partner is over 35 you may also consider seeking help after 6 months of trying to conceive.


The first step is getting basic infertility testing. These tests results help to diagnose what is preventing conception and guides the infertility doctor in selecting a patient’s treatment. Because infertility can also be related to a male factor, it is essential that the male be tested as well as the female. The majority of the time these initial diagnostic tests will provide an accurate diagnosis. In some cases, additional testing is necessary.

Infertility testing is designed to answer 3 basic questions related to the health of the female and male reproductive system:

Are Your Ovaries Healthy? 

Ovarian function is evaluated by hormonal studies.  The following blood tests are obtained on day 3 of the menstrual cycle.

  • FSH (follicle stimulating hormone) and LH (luteinizing hormone) – these hormones are secreted by the brain and help the process of ovulation each month- these levels can give a doctor insight into how well the brain and the ovary communicate and can signal any decline in ovarian function as a result of aging.
  • E2 (estradiol) – this hormone is secreted by the ovary and gives insight into the function of the ovary itself

Depending on the diagnosis, additional ovarian testing may be recommended. Click here more information on Ovarian Reserve Testing.


Are Your Uterus and Fallopian Tubes Normal?

Fertilization occurs in the fallopian tubes and fertilized embryos implant in the uterus.  Tests may be performed to determine if the uterus and fallopian tubes are structurally normal. These tests are scheduled between the end of menses and the onset of ovulation.

The most common screening test ordered is called a Hysterosalpingogram (HSG) —  this is an X-ray test that uses a dye to make sure the cavity of the uterus is normal and that the fallopian tubes to make sure that they are open and unblocked.  There are other additional tests/ procedures that your doctor may order depending on your medical history.

Are the Sperm Normal?

The initial basic test performed on the male is called a semen analysis. Andrologists (sperm specialists) look at a semen sample under the microscope to evaluate its quality based on three parameters:

  • Count – total number of sperm – are there enough? 
  • Motility – forward movement of the sperm- are the sperm swimming well?
  • Morphology – do the sperm have normal form and shape?

If any of these parameters are low, then the fertilization potential of the sperm is decreased and a male factor may be the cause of infertility.

The good news is that many patients insurance will cover these initial diagnostic tests and they can be ordered by your primary ob/gyn even before you make the decision about seeing a fertility specialist. 

The hardest part of any journey is taking the first step…


If you have struggled with the unfulfilled dream of having a child then you should seek the help of a physician.  With this basic testing often the problem can be diagnosed and you can renew the hope of starting your family.

Blog written by Anitha Nair, MD
Dr. Nair is specialty trained reproductive endocrinologist, also known as a fertility specialist working at Shady Grove Fertility...