Female Fertility Evaluation

History & Physical Exam

• Menstrual cycle regularity
• Past pregnancies, miscarriages
• Gynecologic conditions (endometriosis, PCOS)
• Surgeries or infections affecting reproductive organs

Dysmenorrhea – Painful menstruation that may include cramps, lower abdominal pain, nausea, or headaches.

• Primary : Pain without underlying disease.
• Secondary : Pain due to conditions like endometriosis or fibroids.

Ovulation Assessment

• Basal body temperature charting (less common now)
• Ovulation predictor kits (urinary LH surge)
• Blood tests : Progesterone (mid-luteal phase)
• Ultrasound : Follicle tracking

Ovarian Reserve Testing

• AMH (Anti-Müllerian Hormone) – indicates egg quantity
• FSH/LH on day 2–3 of cycle
• Antral follicle count via ultrasound

Tubal Patency

• HSG (hysterosalpingogram) – X-ray with contrast to check fallopian tubes
• Sonohysterogram with saline or Sonohysterography with contrast
• Hysteroscopy/laparoscopy if needed

Uterine Evaluation

• Ultrasound to check for fibroids, polyps, or congenital abnormalities

Fertility Treatment Options

Lifestyle & General Measures

• Maintain healthy weight
• Stop smoking/alcohol, reduce caffeine
• Balanced diet and moderate exercise
• Optimize timing of intercourse

Ovulation Induction (for women with ovulation problems)

• Clomiphene citrate – oral
• Letrozole – oral, often first-line for PCOS
• Gonadotropins (FSH, LH injections) – more advanced

Intrauterine Insemination (IUI)

• Sperm is processed and placed directly in the uterus around ovulation
• Often combined with ovulation induction