While multiple factors can result in sub-fertility, the three major ones pertain to the sperm, the eggs and female pelvic anatomy. Many patients start their infertility workup before coming to the Alta Bates IVF Program but frequently not all the essential tests have been completed. A thorough review of past evaluation and treatment, however, helps avoid unnecessary re-testing and associated expenses.
Below is a list of the minimum screening tests:
I. Male Factors: Semen Analysis.
II. Ovarian Factors: Cycle day 3 FSH and Estradiol. Cycle day 21 progesterone. Ultrasound assessment of antral follicle count. Anti-Mullerian Hormone.
III. Tubal and Uterine Factors: HSG (hysterosalpingogram).
On the basis of these few tests most couples can be assigned to broad categories depicted on the pie-chart below.
However, this type of categorization is of limited value inasmuch many infertile couples have multiple factors simultaneously and no allowance is made for female age or reduced ovarian reserve which often presents the single greatest challenge (What Is Age Factor? How Do We Test Ovarian Reserve).