An infertility workup is a comprehensive medical evaluation performed on couples who are unable to conceive after 12 months of regular, unprotected intercourse (or 6 months for women over 35). It helps identify the underlying causes of infertility and guides appropriate treatment options. The process typically includes hormonal tests, ultrasound scans, semen analysis, and imaging to assess reproductive health in both partners.
Infertility can occur due to a variety of medical, hormonal, structural, and lifestyle-related factors affecting either partner.
In women, infertility is often linked to irregular ovulation or hormonal disorders such as Polycystic Ovary Syndrome (PCOS). Other contributing factors may include blocked fallopian tubes, uterine abnormalities, fibroids, or conditions like endometriosis.
In men, infertility may result from a low sperm count, poor sperm movement, or abnormal sperm shape. These issues can arise due to hormonal imbalances, genetic conditions, infections, or lifestyle habits such as smoking, alcohol consumption, or exposure to harmful chemicals.
Additional common factors affecting fertility in both partners include age, stress, obesity, sexually transmitted infections (STIs), and certain chronic medical conditions. Identifying the underlying cause early and seeking timely medical care can significantly improve the chances of conception, either naturally or through fertility treatments.
Infertility evaluation is usually the first step when a couple is unable to conceive after regular, unprotected intercourse. This assessment involves a combination of medical history, physical examinations, and specific diagnostic tests for both partners.
For men, semen analysis is performed to assess sperm count, movement, and structure.
For women, ovulation is monitored through hormone tests, ultrasound scans, or ovulation predictor kits.
Once the cause is identified, appropriate infertility treatment options can be planned.
Before the physical examination, a detailed medical history is taken to:
Evaluate menstrual cycle regularity, flow, and ovulation patterns
Identify concerns such as declining ovarian reserve, fibroids, or uterine abnormalities
Review any history of STIs, painful periods, pelvic pain, or previous abdominal surgeries
Understand lifestyle habits including smoking, alcohol intake, stress, and exercise
Pap Smear
Helps detect abnormal cervical cells, infections, or early signs of cervical cancer that may affect fertility.
Urine Test (Ovulation Test)
Measures luteinizing hormone (LH), which surges just before ovulation.
Blood Tests
Hormone levels such as FSH (Follicle-Stimulating Hormone) are tested to evaluate ovarian function and egg development.
Postcoital Test
Examines cervical mucus after intercourse to assess sperm survival and movement.
Hysterosalpingogram (HSG)
An X-ray test that checks whether the fallopian tubes are open and evaluates the shape of the uterus using contrast dye or saline with ultrasound.
Hysteroscopy
A thin camera is inserted through the cervix to directly view the uterine cavity and detect abnormalities. Tissue samples may also be collected if needed.
Transvaginal Ultrasound
Allows detailed visualization of the uterus and ovaries to identify cysts, fibroids, or ovulation status. Progesterone levels may also be checked to confirm ovulation.
Endometrial Biopsy
A small sample from the uterine lining is taken to assess whether it is suitable for implantation.
Not every test is required for every patient. Your doctor at Naarayani will recommend tests based on individual needs. In nearly 85% of couples, testing helps identify the cause of infertility.
Male fertility evaluation plays a vital role in diagnosing infertility and planning effective treatment. It includes a detailed medical history, physical examination, and laboratory investigations.
The medical history helps to:
Review past illnesses, surgeries, or medications
Identify hereditary or congenital fertility issues
Assess exposure to toxins, occupational hazards, and lifestyle factors
Urinalysis
Detects infections or abnormalities in the urinary tract.
Semen Analysis
Evaluates sperm count, motility (movement), and morphology (shape).
Normal sperm count: at least 20 million sperm per milliliter
Normal motility: about 60% moving sperm
Morphology assesses the percentage of normally shaped sperm
Hormonal Tests
Measures testosterone, FSH, and sometimes LH or prolactin to assess hormonal balance and sperm production.
Genetic Testing
Recommended in cases of very low sperm count to detect chromosomal abnormalities or inherited conditions affecting fertility.
Ultrasonography
Scrotal ultrasound helps identify blockages, varicocele, or other structural problems in the reproductive organs.
Once diagnostic testing is complete, fertility specialists at Naarayani determine the most suitable treatment approach. This may include:
Lifestyle modifications
Medications or hormonal therapy
Surgical correction
Assisted reproductive techniques such as IVF, ICSI, or IUI
Infertility can be emotionally and physically challenging, impacting relationships and mental well-being. If conception has not occurred despite consistent efforts, it is important to consult experienced fertility specialists.
With expert guidance, personalized treatment plans, and advanced reproductive technologies, Naarayani helps transform the dream of parenthood into reality.