Fertility evaluation in a female usually begins after one year of unprotected intercourse. However, if the presenting age of the female is more than 35 or if there are other co morbid conditions like endometriosis, irregular periods, fibroids in the uterus or history of infections affecting the tubes, then women are asked to consult our gynecologist sooner. A thorough history taking is mandatory as in male fertility. Duration of infertility, menstrual history, history of infections, gynecological history , sexual history and family history are of paramount importance.
A thorough physical examination looking for features of incomplete development of secondary sexual characters is recorded. Abdominal obesity is noted. Abnormalities of the thyroid gland, breast and acne are looked for. A pelvic exam might reveal tenderness in the vagina hinting at endometriosis. Abnormalities in the vagina and cervix are noted. The three main things that fertility specialists focus on are:
- Assesment of Ovulatory function
- Tubal patency
- Assesment of Uterine Cavity