Texas Fertility Center San Antonio

Infertility Evaluation

A complete infertility evaluation is the first step of creating your treatment plan

If you’ve been struggling to conceive for one year (if you are a female under 35 years of age) or six months (if you’re 35 or over), it’s time for an infertility evaluation. By ordering comprehensive testing, Erika Munch MD can determine the cause of your fertility issues. In order to conceive, a couple needs a healthy uterus, ovaries that contain plenty of eggs, open fallopian tubes and normal sperm. As a result, your diagnostic testing with our San Antonio infertility doctor will focus on evaluating these factors.

Taking a medical history is the first step on your journey

When you visit Dr. Munch, she will first want to know about your medical history. Our San Antonio infertility doctor will ask about your health, menstrual cycle, lifestyle, and past pregnancies and fertility treatments. After gathering this history, she will typically perform a physical examination. The information Dr. Munch gathers from your history and physical will help her determine what other evaluation you will need.

The infertility evaluation for women may involve bloodwork and other testing

Many diagnostic tests are available to help Dr. Munch learn more about your fertility struggles. Although you may not need all of them, it is helpful to understand what each test entails.

  • A transvaginal ultrasound exam typically occurs at your first visit. During this simple test, Dr. Munch uses a vaginal probe to view your uterus and ovaries. She will look for a variety of issues, including uterine fibroids, endometrial polyps, endometriosis and ovarian cysts. The ultrasound examination can occur any time during your menstrual cycle.
  • Ovarian reserve testing can provide valuable information about the number of eggs remaining in your ovaries. Although it’s not possible to get a precise count, drawing blood on the third day of the menstrual cycle can provide a good estimate. The two tests most commonly used for determining ovarian reserve are follicle-stimulating hormone (FSH) and anti-Mullerian hormone (AMH).
  • Other types of bloodwork may be necessary as part of the infertility evaluation if you do not ovulate regularly. These include tests for prolactin and thyroid-stimulating hormone (TSH). If we suspect you have polycystic ovary syndrome (PCOS), Dr. Munch may also recommend a 2-hour glucose tolerance test (GTT).

In addition, our San Antonio infertility doctor may order a hysterosalpingogram (HSG) to determine whether your uterine cavity is normal, and your fallopian tubes are open. This exam involves inserting a small catheter through the cervix into the uterus. Under X-ray guidance, a dye is placed into the uterus so that we can make sure that the uterine cavity has a normal shape and size and also to make sure that the fallopian tubes are both open.

A semen analysis provides valuable information about the male partner

Up to 50% of cases of infertility are caused by abnormalities in sperm production or function, so it is important to evaluate the man using a semen analysis. To do this, we will ask the male partner to obtain a sperm specimen either at home or at the Ovation-San Antonio laboratory. If the collection occurs at home, the specimen needs to arrive at the laboratory within one hour of the time it was collected.

Once the specimen arrives, our andrologists evaluate it under a microscope for volume, sperm concentration (the number of sperm per cc of semen), sperm motility (movement) and sperm morphology (shape).

Follow-up consultation after the infertility evaluation

After the testing is complete, you will come back to the office to discuss the results of all of your tests with Dr. Munch. Based on the results, she will be able to explain your chances of pregnancy using different fertility treatments. Following this discussion, our San Antonio infertility doctor will help you develop a treatment plan to get you started on the path to pregnancy. Contact us to schedule an appointment and learn more.