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Unraveling Infertility: A Guide To The Basic Infertility Workup

Infertility, defined as the inability to conceive after a year of regular, unprotected intercourse, affects 10-15% of couples globally. Audubon Fertility offers a basic infertility workup to identify factors contributing to infertility, whether from female, male, or combined causes.

Infertility can have a significant emotional impact on individuals and couples. It can lead to feelings of frustration, sadness, anger, and isolation. It is important to remember that infertility is not a personal failing, and there are many things that couples can do to improve their chances of conceiving.

Understanding The Infertility Workup

An infertility workup is a series of tests and assessments conducted to identify the underlying

Basic Infertility Workup

causes of a couple's fertility challenges. The workup typically involves both partners, as infertility can be caused by factors in either the male or female partner.

The infertility workup typically begins with a comprehensive medical history and physical examination for both partners. The fertility specialist will also review the couple's lifestyle factors, such as diet, exercise, and substance use.

In addition to the medical history and physical examination, the infertility workup may also include a variety of laboratory tests and imaging studies. These tests can help to assess the following:

  • Ovulation function

  • Sperm health

  • Reproductive organ anatomy and functionality

  • Hormonal levels

  • Genetic factors

Medical History And Lifestyle Assessment

The medical history and lifestyle assessment is an important part of the infertility workup. The fertility specialist will ask detailed questions about the couple's medical history, including previous pregnancies, menstrual history, sexual health, and any other relevant medical conditions. The fertility specialist will also assess the couple's lifestyle factors, such as diet, exercise, and substance use.

Previous Pregnancies

The fertility specialist will ask about any previous pregnancies, including miscarriages, stillbirths, and ectopic pregnancies. This information can help the specialist to identify any potential risk factors for infertility.

Menstrual History

The fertility specialist will ask about the woman's menstrual history, including the age at menarche, the regularity of her menstrual cycles, the length of her cycles, and the amount of bleeding.

Sexual Health

The fertility specialist will ask about the couple's sexual health, including any history of sexually transmitted infections (STIs). STIs can damage the reproductive organs and lead to infertility.

Other Medical Conditions

The fertility specialist will also ask about any other medical conditions that the couple may have, such as thyroid disease, diabetes, or endocrine (hormone) disorders..

Lifestyle Factors

The fertility specialist will also assess the couple's lifestyle factors, such as diet, exercise, and substance use. Certain lifestyle factors can have a negative impact on fertility. For example:

  • Diet: A healthy diet is important for overall health and fertility. A diet that is low in processed foods and high in fruits, vegetables, and whole grains can help to improve fertility.

  • Exercise: Regular exercise is also important for fertility. Exercise can help to improve hormonal balance, reduce stress, and promote overall health.

  • Substance Use: Smoking, excessive alcohol consumption, and drug use can all decrease fertility in both men and women.

Importance of Openness And Honesty

It is important to be open and honest with the fertility specialist during the medical history assessment. This will help the specialist to get a complete picture of your health and fertility history, which is essential for developing an accurate diagnosis and treatment plan.

Don't be afraid to ask questions or discuss any concerns you may have. The fertility specialist is there to help you and your partner achieve your dream of parenthood.

Physical Examinations And Laboratory Tests

The fertility specialist will focus on examining the reproductive organs and overall health of both partners. Often the REI (Reproductive Endocrinology & Infertility) specialist will examine a female partner and a Urologist will examine a male partner.

In addition to the physical examinations, the fertility specialist may also order a variety of laboratory tests. These tests may include:

  • Preconception labs. These include a list of blood tests that will help ensure that your body is healthy and ready for pregnancy.

  • Genetic carrier screen. This is a blood test done on the patient and partner or gamete donor(s) that is used to determine if there is any risk of transmitting a genetic disease to the child.

  • Hormone assessments to measure levels of key reproductive hormones, such as estrogen, progesterone, thyroid hormone,, and testosterone. These can help diagnose an ovulatory dysfunction and its potential cause.

  • Ovarian reserve testing. This is done with a blood test called AMH (anti-mullerian hormone) and an ultrasound to determine one’s AFC (antral follicle count). Ovarian reserve testing is helpful to counsel patients on their treatment options and chance of a successful outcome.

  • Semen analysis to assess the quality and quantity of sperm.

  • Imaging studies, such as a pelvic ultrasound to visualize the uterus and ovaries. A Hysterosalpingography (HSG), is sometimes ordered to visualize the Fallopian tubes to determine if they are open or blocked.

Additional Evaluations

In some cases, the fertility specialist may recommend additional evaluations, such as hysteroscopy or laparoscopy. These specialized tests can provide a more in-depth assessment of the reproductive anatomy and functionality.

The fertility specialist may also recommend genetic testing if there is a family history of infertility or if other factors suggest that genetic factors may be playing a role in the couple's fertility challenges.

Interpreting Results And Personalized Care

The results from the infertility workup will guide the development of a personalized treatment plan for the couple. The fertility specialist will work closely with the couple to discuss their options and develop a plan that is best for them.

Personalized Treatment Plans

The best treatment plan for each couple will vary depending on the underlying causes of their infertility and their individual needs and preferences. There is no one-size-fits-all approach to infertility treatment.

Some common infertility treatments include:

  • Timed Intercourse: The fertility specialist can track the woman's ovulation cycle and recommend the best days for intercourse.

  • Ovulation Induction: The fertility specialist may prescribe medications to help the woman ovulate more regularly or increase the number of eggs they ovulate.

  • Intrauterine Insemination (IUI): The fertility specialist places washed sperm directly into the woman's uterus.

  • In Vitro Fertilization (IVF): The fertility specialist collects eggs from the woman and sperm from the man and fertilizes them in a laboratory. The fertilized embryos are then transferred to the woman's uterus.

Collaborative Approach

The fertility specialist will work closely with the couple to discuss their options and develop a treatment plan that is best for them. The fertility specialist will explain the risks and benefits of each treatment option and help the couple to make an informed decision.

Clear Communication

It is important for the couple to have clear communication with the fertility specialist throughout the infertility workup and treatment process. The couple should ask questions and express any concerns they may have. The fertility specialist should be willing to explain everything in detail and answer all of the couple's questions.

Patient's Active Involvement

The patient should be actively involved in the decision-making process throughout the infertility workup and treatment process. The patient should feel comfortable asking questions and sharing their preferences with the fertility specialist.


The infertility workup is an essential step in diagnosing the root causes of fertility challenges and developing a personalized treatment plan. Audubon Fertility's team of experienced and compassionate fertility specialists is committed to helping couples achieve their dream of parenthood.

If you and your partner are facing challenges in conceiving, schedule a consultation with one of our fertility specialists. We will work with you to develop a comprehensive infertility workup and personalized treatment plan to help you achieve your fertility goals.


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