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New Committee Opinion on Female Fertility Testing
Susannah D Copland, MD, MS posted:
New Guidelines on Fertility Testing!
American Society for Reproductive Medicine (ASRM) released a Committee Opinion on evaluation of the infertile female in August 2012. This new Committee Opinion focuses on testing that is cost-effective, expedient, and minimally invasive. Here is the first installment of a three part summary:
When is testing appropriate?
85% of women will be pregnant within a year of trying, so testing is indicated for the other 15% who have not yet conceived after a year. Testing may start sooner if you suspect a fertility concern: age over 35 years, history of irregular periods, suspected scar tissue or endometriosis, suspected sperm problems. Women planning to use a sperm donor may also desire some level of pre-insemination testing.
Questions your doctor will ask you:
How long have you been trying?

  • · your periods (how many days from first day to first day, any pain?)
  • · any prior pregnancies
  • · any prior birth control
  • · frequency of intercourse
  • · surgery, injury, infection to the reproductive tract
  • · treatments for abnormal pap smears
  • · family history of birth defects, mental retardation, menopause, reproductive problems
  • · use of cigarettes, alcohol, recreational drugs.

Reasons for the tests your doctor may offer:
Do you release an egg?
15% of infertile women do not ovulate robustly. Many times women with ovulation problems will have abnormal bleeding or irregular periods, however in some instances ovulation problems can be more subtle.
Evidence that you are ovulating:

  • · regular predictable periods occurring within the interval 25-35 days
  • · greater than ten days of basal body temperature elevation each cycle
  • · positive mid cycle ovulation predictor kit
  • · Blood progesterone test greater than 3, 1 week before the period

Testing that may be offered if you are not ovulating well:

  • · Thyroid
  • · Prolactin
  • · Follicle stimulating hormone with estradiol

My next installment with cover How many eggs do you have? And how do test fallopian tubes?
Have a great week!
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