Infertility Question and Answer… Getting to Know How Infertility Tests and Treatments Work

*Question: How is infertility tested?

On your first visit to a fertility specialist, you will receive an examination to rule out initial fertility problems. The fertility specialist with physical examinations and sexual and medical histories for both you and your partner.

Once the physical examinations have been completed, your fertility specialist will run some tests. Generally, men undergo semen specimen tests where the sperm will be evaluated based on the volume per ejaculation, its shape, and its movement (or motility). Some doctors will give other tests such as hormone tests.

For a woman, the doctor will try to determine if she is ovulating properly every month. To determine this, she will be asked to either record her temperature every morning and her cervical mucous texture or she will need to use a home ovulation test kit. Additional ovulation testing may be necessary. These tests may include blood tests for determining hormone levels and ultrasound tests for determing the health of the ovaries.

*Question: How can you treat for infertility?

Treatment for infertility depends on the physical examination and test results. In most cases, 85 to 90 percent of infertility cases are treated with prescription drugs or surgery.

There are several different fertility drugs that can be taken by women having ovulation problems. However, it is essential that you speak with your physician and let him prescribe the right drugs for your situation. He is the best person to explain to you the possible side effects as well as the possible benefits.

Surgery can be done in cases where fertility problems are caused by damage or other problems in the reproductive organs of either the man or the woman.

*Question: What medicines do doctors use for treatment of infertility in women?

If a woman has ovulation complications, the drug Clomiphene Citrate is often prescribed. It is common for this drug to be used for women experiencing Polycystic Ovarian Syndrome or other disorders causing problems with ovulation.

The human menopausal gonadotropin (hMG) is the drug most often prescribed for women who are not ovulatiing due to problems with pituitary glands. It acts directly on the ovaries and encourages ovulation.

A few other ovary medications such as follicle-stimulating hormone (FSH) and gonadotropin-releasing hormone (Gn-RH) are also sometimes prescribed for women with fertility problems. These medications usually come in the form of injections.

Metformin is generally used to treat women who have high levels of male hormones which interfere with ovulation. Metformin may be combined with FSH.

Another common fertility drug, Bromocriptine is often prescribed for women having complications with ovulation caused by high levels of prolactin, the hormone responsible for lactation and producing milk.

*Question: Will my insurance plan cover treatments I need for infertility?

While you will find insurance plans that cover infertility treatments, such coverage is generally dependent on where you are from and your insurance policy. Presently, there are 12 states that have enacted laws that require providers of insurance to cover infertility diagnosis and treatments, either in full or in part. Those states that have passed such laws include:

- Arkansas

- California

- Connecticut

- Hawaii

- Illinois

- Maryland

- Massachusetts

- Montana

- New York

- Ohio

- Rhode Island

- Texas

The laws enacted in the above states may differ in their reach as well as the items that must be covered. If you need further information regarding insurance coverage on the treatment and diagnosis of infertility, look up the website of the American Society for Reproductive Medicine and click on the State Infertility Insurance Laws link.

The Day in Medicine

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