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Investigation

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

General considerations:

  • remember that infertility may be multi-factorial
  • rate of conception decreases with age - due to both decreased frequency of intercourse and to poorly defined effects on fertility
  • start with relatively simple, non-invasive tests; delay operative evaluation for the first 6 - 8 months

Investigations may include:

  • history and examination of both partners
  • semen analysis
  • assessment of ovulation - mid-luteal progesterone - taken seven days prior to menses e.g. day 21 of 28 day cycle or day 25 of 32 day cycle; other methods include basal body temperature, endometrial biopsy
  • other hormonal tests - LH, FSH, TFT's, testosterone, DHEA, sex hormone binding globulin, PRL - performed on day 2, 3 or 4 of cycle
  • assessment of cervical compatibility - post coital test, mucus invasion test
  • assessment of tubal patency - hysterosalpingography, laparoscopy
  • assessment of pelvic adhesions, endometriosis - laparoscopy
  • rubella status - this should be checked prior to the commencement of any treatment; if a patient is non-immune then they should be vaccinated and advised to avoid pregnancy for 3 months

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