Sterility or infertility could be caused by a woman's body, a man's body, or both in combination. If you are trying to conceive, you should be having unprotected sex during the fertile days of your menstrual cycle. If you've been TTC for more than 9 months without success you may consider sterility as a possible cause and you can seek medical help. First, the man should be checked because medical examinations for sterility in men are simpler and easier than for women. Men give a sperm sample (spermogram). A normal spermogram requires:
1. Ejaculate received 4-5 days after sexual abstinence and must contain 2-6.5 ml sperm;
2. A normal spermogram has more than 20 millions spermatozoids in 1ml of sperm;
3. A normal spermogram has more than 50% living, moving spermatozoids with normal morphology;
4. The number of leucocytes in a normal spermogram is less than 1 million in 1 ml sperm;
5. The fructose levels of a normal spermogram is more than 13 µmol/ml sperm, and
6. MAR-test is negative.
A normal spermogram is not a guarantee for good fertilization ability... so functional sperm-analyses are also performed to test for fertility. Functional tests reveal the spermatozoids’ ability to surviving in seminal plasma, to penetrate the plasma, stimulate and conceive.
Hormonal analyses (testosterone, FSH and LH), chromosome analyses and testicular biopsy are done later if necessary.
If everything is OK with your partner, then it would be your turn. Medical examinations for sterility in women are more complicated and more difficult than for men. The task of these examinations is to examine the function of the axis hypothalamus-pituitary gland-ovaries and the anatomy of the reproductive organs. They include:
1. A vaginal examination with a colposcopy, Pap-test and microbiological examinations for STDs;
2. Hormonal analyses (estrogen, progesterone, FSH. LH, prolactin, thyroxin, testosterone, DHEA);
3. Ultrasound-scan;
4. HSG (X-ray contrast method for revealing the passage trough the uterus and oviducts);
5. Hysteroscopy and laparoscopy (performed later if necessary).
You can consult your gynecologist for a referral to a fertility specialist in your area.
