Examinations to discover the cause for infertility are normally started when a couple has unsuccessfully tried to conceive a child for one year. If there are already known factors affecting fertility the treatment can be started earlier (these causes include surgical operations on the fallopian tubes, ovaries or the uterus, irregular menstruation, male testicular diseases etc). In order to diagnose the cause for infertility, we aim to address three main questions:
1) Does the maturation of the egg and ovulation occur in a normal way?
2) Is the anatomy of the female reproductive organs normal, that is, are the uterus and the fallopian tubes functionally healthy?
3) Is there sufficient number of mobile sperm cells for fertilization?

A) Female infertility

Does the maturation of the egg and ovulation occur in a normal way?

If the woman has a regular period of 25-35 days it is most likely that the maturation of the egg and ovulation are normal. An ultrasound scan will confirm a normal growth of the follicle. You can also estimate the time of ovulation with urine tests at home (the LH test). If needed, blood tests are done to confirm that ovulation occurs (serum progesterone one week after ovulation).

Is the anatomy of the female reproductive organs normal, that is, are the uterus and the fallopian tubes healthy?

Tubal patency used to be confirmed by laparoscopy or hysterosalpingography (radiological examination with contrast medium). These methods can still be used in certain special cases, but normally the first examination entails an ultrasound scan combined with hydrosonography or salpingosonography (SSG). If the fallopian tubes are blocked the treatment of choise is in vitro fertilization (IVF). The most common causes for damaged fallopian tubes are infectious diseases (for example chlamydia), endometriosis, ectopic pregnancy and surgical operations on the ovaries and the fallopian tubes.

B) Male Infertility

Is there sufficient number of mobile sperm cells for fertilization?

Male fertility may be examined with a microscopic examination of the sperm where special attention is paid to the quantity and the motility of the sperm cells. Based on this examination it is possible to give an evaluation concerning the fertility of the man. The quality of the semen may vary considerably over time. A reduced sperm count and lower mobility of the sperm cells may be due to infectious diseases (such as chlamydia or the mumps), a testicular injury, certain medication, use of anabolic steroids and dissolvents, or smoking, but often the cause remains unclear. In addition, hereditary causes are a possible reason for a low sperm count or poor motility of the sperm.