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Female Infertility Diagnosis

 
Dr. Richard Paulson
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USC Fertility
  • How will my doctor test for female infertility?
  • What is a "hysterosalpingogram" or "HSG"?
  • What is a "pelvic ultrasound"?
  • How will my doctor test for male infertility?
  • Are infertility tests commonly covered by insurance?
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Female Infertility
 Infertility Basics 
  1. Dr. Richard Paulson
  2. What is "infertility"? 
  3. What is the average time it takes to conceive? 
  4. How long should I wait to see a doctor about whether or not I am fertile? 
  5. How common is infertility? 
  6. What factors can prevent me from becoming pregnant? 
  7. What are the leading causes of infertility among women? 
  8. What is "polycystic ovary syndrome" or "PCOS"? 
  9. How is "pelvic inflammatory disease" related to infertility? 
  10. How can other preexisting health problems affect female infertility? 
  11. What are my chances of getting pregnant after the age of 30? 
  12. What precautions should I take if I hope to conceive in my thirties or forties? 
  13. What causes male infertility? 
  14. What are some of the myths about male infertility? 
Female Infertility Diagnosis (Now Playing)
  1. Dr. Richard Paulson
 Infertility Treatment Basics 
  1. Dr. Richard Paulson
  2. How do I find a qualified infertility doctor? 
  3. What treatments are available for male infertility? 
  4. What treatments are available for female infertility? 
  5. Are there specific fertility treatments for women over the age of 35? 
  6. What are the emotional consequences associated with infertility treatments? 
  7. What are the clinical trials currently being done regarding infertility? 
  8. What is "laparoscopic surgery"? 
  9. What is "intrauterine inseination" or "IUI"? 
  10. What medications are used for intrauterine insemination? 
 Preventing Infertility 
  1. Dr. Richard Paulson
  2. What changes in my lifestyle may increase my fertility? 
  3. Is it true that "relaxing" about my fertility will improve my chances? 
  4. What some myths about preventing infertility? 
 Ovulation Induction Fertility Treatments 
  1. Dr. Richard Paulson
  2. What is "ovulation induction"? 
  3. What is "ovarian hyper-stimulation syndrome" or "OHSS"? 
  4. What is "clomiphene citrate"? 
  5. What is a "human menopausal gonadotropin" or "HMG"? 
  6. What is a "follicle-stimulating hormone" or "FSH"? 
  7. What is a "gonadotropin-releasing hormone" or "GnRH"? 
  8. What is "human chorionic gonadoptropin" or "hCG"? 
  9. What is "metformin"? 
  10. What is "bromocriptine"? 
 Assisted Reproductive Technology 
  1. Dr. Richard Paulson
  2. What is "assisted reproductive technology"? 
  3. What are some possible side effects of assisted reproductive technology? 
  4. What is a "gamete intra-fallopian transfer" or "GIFT"? 
  5. What is a "zygote intra-fallopian transfer" or "ZIFT"? 
  6. What is an "intra-cytoplasmic sperm injection" or "ICSI"? 
  7. What is "follicle aspiration, sperm injection and assisted follicular rupture" or "FASIAR"? 
  8. How often do assisted reproductive technology treatments produce multiple children? 
  9. Are any major lifestyle changes necessary while undergoing assisted reproductive technology treatments? 
  10. Are assisted reproductive technology treatments expensive? 
  11. Do insurance plans normally cover assisted reproductive technology treatments? 
 In Vitro Fertilization 
  1. Dr. Richard Paulson
  2. What is "in vitro fertilization" or "IVF"? 
  3. What are "oocytes" or "eggs"? 
  4. How long does it normally take to become pregnant using in vitro fertilization? 
  5. What factors can affect the success of in vitro fertilization? 
  6. How are my eggs collected for in vitro fertilization? 
  7. What are the benefits and disadvantages of using my own eggs for in vitro fertilization? 
  8. What are the benefits and disadvantages of using frozen eggs for in vitro fertilization? 
 Oocyte Donation 
  1. Dr. Richard Paulson
  2. What are some of the health risks of in vitro fertilization? 
  3. What is "oocyte" or "egg donation"? 
  4. How do I get donor eggs for in vitro fertilization? 
  5. What are the legal rights of egg donors and their recipients? 
Richard Paulson Dr. Richard Paulson
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Transcript

Female Infertility Diagnosis

How will my doctor test for female infertility?

If we have a couple who comes and they say they've been trying for a year and it's not working, or perhaps we even have a woman come to the office by herself and say, "I'm getting married next month; I really want to make sure my fertility is normal," the kinds of tests we run really pertain to the two main factors that are important in a woman's fertility. One of them is ovulation and the other one is the presence of a normal uterus and normal fallopian tubes. For ovulation, first of all we get a history, because if someone has regular menstrual cycles, the chances are 90 percent that they're ovulating. Another way of thinking of that is that a woman who has regular cycles has a ten percent chance of not ovulating. It's really quite simple to do a blood test for progesterone in what we call the Late Luteal Phase or perhaps even to have the patient do a urinary ovulation kit at home and see that she is ovulating during a particular time of the cycle. For the uterus and the fallopian tubes, there are a number of tests that can be done. The simplest by far is the X-ray, which is called a hysterosalpingogram, or HSG. In other instances we may do a laparoscopy or some other kind of imaging study, for example an ultrasound, to verify that the uterus and the fallopian tubes are normal.

What is a "hysterosalpingogram" or "HSG"?

What is a "pelvic ultrasound"?

How will my doctor test for male infertility?

It's important to remember that it takes two to make an embryo. So, just as there are female factors involved in infertility, there are male factors in infertility. The male has to produce a sufficient number of sufficiently viable sperm to be able to achieve fertilisation, and the delivery of the genetic material from the sperm into the egg that causes that egg to become an embryo. The best test that we have for this is a simple semen analysis. In other words, the man is asked to produce a specimen, typically into a cup or other kind of container, and then this sample is analysed in the laboratory. We measure the volume of the semen, we look at the concentration of sperm within the sample, we look at what proportion of the sperm are swimming, and then we also look under high magnification to see what proportion of the sperm heads have a normal shape. If the sperm heads are abnormally shaped, this may be an indication of male factor infertility, and a strong indication that if we put those sperm in with an egg, that fertilisation in fact will not be achieved. It's important to realise that semen analyses vary from time to time, and therefore, that first of all we need a standardised period of time of abstinence, meaning a lack of ejaculation for at least forty eight hours, and no more than seven days. Also it's important to repeat the test at least once. In other words, it's good to have at least two tests to substantiate that whatever the finding is, is really true; that a normal sperm is normal again, perhaps a month later, or that an abnormal sperm specimen is an indication of an abnormal semen analysis.

Are infertility tests commonly covered by insurance?

Insurance coverage for infertility testing and infertility treatment is extremely variable in different parts of the country. For example, in New York, Massachusetts, Illinois there is what is called “manadated coverage,” so couples have coverage both for the testing as well as for the treatment. In other states, the diagnostic testing is covered but not the treatment. In other states nothing is covered at all. You really have to check with your insurance carrier. Here in California, the majority of insurances do not anything to do with infertility. Some insurance companies do cover the diagnostic testing, but generally exclude any kind of treatment, whether it is insemination or fertility medications or even in vitro fertilization. We've been working long and hard to get this changed, so perhaps by the time you're seeing this, the circumstances surrounding this issue will have changed.

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  • How will my doctor test for female infertility?
  • What is a "hysterosalpingogram" or "HSG"?
  • What is a "pelvic ultrasound"?
  • How will my doctor test for male infertility?
  • Are infertility tests commonly covered by insurance?

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