What is infertility?
Most doctors consider a couple infertile if the woman hasn't been able to get pregnant after trying for one year. A woman who becomes pregnant but has repeated miscarriages is also considered infertile. Infertility is not a single disease but can be the result of any of a number of medical conditions. In approximately one-third of cases, it stems from a problem with the woman's reproductive system, in an equal number of cases, the problem is with the man. In 20% of cases, it's a combination of factors involving both partners.

What causes infertility?
Here are some medical conditions that can lead to infertility problems:

Pelvic Inflammatory Disease (PID)
PID is caused by an infection, typically a sexually transmitted disease like chlamydia or gonorrhea. Bacteria attack the ovaries, fallopian tubes, uterus, and other organs in the pelvic region, sometimes creating bands of scar tissue called adhesions that can lead to blocked fallopian tubes. A cervical culture can be done to test for chlamydia and gonorrhea. Every infertility patient will have a screening culture done at the beginning of the infertility evaluation as an infection may be present without showing any symptoms.

Age-Related Factors
As a woman ages, the number of chromosomal abnormalities in her eggs increases. Abnormal eggs are unable to go through the normal cell division that results in a healthy thriving embryo. Research shows that female infertility drops from normal rates at age 35 to near zero at age 43.

Endometriosis
Patches of endometrium, the tissue that normally lines the uterus, can also grow outside the uterus - in or around the fallopian tubes and ovaries or in other abdominal or pelvic locations. This misplaced tissue can cause pain and lead to the formation of cysts and scar tissue. It can decrease the chances of conception and increase the risk of miscarriage.

Ovulation Disorders
A number of conditions - from hormonal imbalances to lifestyle factors like stress, smoking and excessive exercising - can disrupt the ovaries normal process of producing and releasing eggs. Disorders of the thyroid, pituitary, or adrenal glands can prematurely shut down a woman's ovaries, causing a form of early menopause called premature ovarian failure; as can the effects of radiation and chemotherapy used to treat cancer.

Hormone Imbalance
Another condition called polycystic ovarian syndrome (PCOS) or polycystic ovarian disease (PCOD), caused by an imbalance of male and female hormones in a woman's body, interrupts the normal development of the egg-producing follicle, triggering the growth of many small ovarian cysts. This disorder can cause excessive hair growth, obesity, lack of ovulation and menstrual cycle disturbances.

Abnormal Cervical Mucus
For sperm to enter the cervix and survive long enough to fertilize an egg, the mucus at the entrance of the cervix needs to have a particular chemical composition and texture. Some women, often because of an infection or hormonal problems, don't produce the right amount or quality of cervical mucus for this process to successfully occur.

Here are other medical conditions that can lead to infertility.

• Sperm Allergy
• Abnormal Sperm Production
• Male Tube Blockages
• Varicocele

For more explanation on any of the conditions listed, please contact our office.

An infertility evaluation is a one hour appointment which begins with a consultation with Dr. Cooper to discuss your concerns and needs. You will have a chance to discuss any testing you have already had performed (so these tests are not repeated) and decide what further testing will be needed. We encourage you to check your insurance booklet under Limitations and Exclusions for your coverage for this type of treatment. Our staff will assist you as needed with finding out benefit information or problems with payment.

Routine Tests



Semen Analysis – A sample of semen is collected to analyze the number and quality of your partner's sperm.

HSG (hysterosalpingogram) - A tube is inserted through the cervix into the uterus so that dye can be injected and an x-ray taken to look for blocked fallopian tubes, scar tissue and other pelvic or uterine abnormalities.

Laparoscopy - A surgeon makes a small incision in the vicinity of a woman's naval and inserts a scope to examine the abdominal cavity for signs of scar tissue, adhesions or endometriosis.

Endometrial Biopsy - Women who have repeated miscarriages may undergo an endometrial biopsy. The doctor takes a small tissue sample from the lining of the uterus shortly after menstruation to determine whether a fertilized egg can implant successfully.

Post Coital Test (PCT) - This test assesses the quality of cervical mucus and the presence and viability of sperm. The woman goes to the doctor’s office within 24 hours of having unprotected intercourse so the doctor can examine a small sample of her cervical mucus under a microscope.