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Infertility workup

In about 25% of opposite-sex couples, it takes more than 1 year of unprotected sex to become pregnant. When 1 year has passed, it is reasonable to start an infertility evaluation, but there may occasionally be reasons to start earlier. For single women and same-sex female couples, the workup can start as soon as there is a deliberate wish to have a child. Infertile women or couples may initially seek care from a gynecologist, at the women’s clinic in the hospital, or contact an IVF clinic directly.

Evaluation of opposite-sex couples

If you have tried to get pregnant for a year without success, you are welcome to book an appointment for an evaluation of your fertility. The workup can start earlier than 1 year if the woman is older than 35 years, if she has very irregular periods, if the man has had previous testicular inflammation, or if any of you have had a diagnosed or suspected Chlamydia infection.

The workup is always carried out at the same time for men and women. On the first visit, you will meet a doctor and together you will review your past medical history, length of infertility, previous pregnancies, and whether disturbances in ovarian or fallopian tube functions are suspected.

The woman’s ovaries and uterus are examined with ultrasound. The ovulatory function is evaluated and hormone tests are carried out to reveal thyroid and pituitary gland disturbances. In most women a more detailed examination of the fallopian tubes (oviducts) is also carried out. In women older than 35 years, it is wise to also test the anti-Müllerian hormone (AMH) level to assess the “egg reserve”, which is an estimation of the quantity of unripe eggs remaining in the ovaries. At the Nordic IVF Clinic, determination of the AMH level is a routine part of the infertility workup.

The man provides a semen sample to assess the amount and quality of his sperm. The sperm analysis is as important as the tests for the woman. Usually, no further investigation of the male factor is needed if the sperm analysis is normal.

Evaluation of same-sex couples and single women

On the first visit, you will meet a doctor and together you will review your past medical history, gynecological diseases, previous pregnancies, and whether disturbances in ovarian or fallopian tube functions can be suspected.

The ovaries and uterus of the woman who will carry the child are examined by ultrasound. The ovulatory function is evaluated and the fallopian tube passages are tested. Hormone tests are taken to rule out thyroid and pituitary gland disturbances. In women older than 35 years, it is wise to also test the anti-Müllerian hormone (AMH) level to assess the “egg reserve”, which is an estimation of the quantity of unripe eggs remaining in the ovaries.

In addition to the medical workup, in Sweden a psycho-social assessment by a behavioral scientist is mandatory for single women as well as for couples before treatment with donated gametes can be performed. The assessment focuses on the recipient’s general capabilities, life situation, and social networks. The Swedish legislation emphasizes children’s rights, and the aim of the assessment is to ensure that the child will grow up in a secure and stable family situation.

What happens next?

The workup results are reviewed and discussed at a personal meeting with the IVF doctor. The doctor goes through the medical tests and laboratory results and informs you about the prognosis and possibilities. The different types of treatment and your options will be presented, and you will have the opportunity to ask questions.

Do you want to book an appointment for your infertility problem? You are welcome to contact our IVF clinics for more information.

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