The doctor will ask questions about your past to try to get clues as to the cause of your infertility. These questions will be regarding your medical, surgical, gynecological, and obstetric history, as well as some “lifestyle” questions. A review of fertility-related records from other doctors that you have seen is also important.
A directed physical exam that may include a pelvic ultrasound should be performed. Ultrasound can help us discover abnormalities with the uterus, fallopian tubes and/or ovaries. We can sometimes see evidence of pelvic scarring, such as when an ovary appears to be stuck to the uterus. We can also get some information regarding the woman’s potential for adequate ovarian stimulation for infertility treatment cycles by counting antral follicles.
Assessment of ovarian reserve
This is a very important assessment of a woman’s remaining egg storage. It is generally done with day 3 FSH and estradiol testing and a vaginal ultrasound assessment of ovarian volume and antral follicle counts
Assessment of adequate ovulation
This can be done in a variety of ways. About 25% of all infertility is caused by an ovulation disorder. One type of ovulation problem, polycystic ovarian syndrome, is usually quite amenable to treatment with medications.