How Fertility Specialists Diagnose Hormonal vs. Structural Causes of Infertility

How Fertility Specialists Diagnose Hormonal vs. Structural Causes of Infertility

Successful fertility treatment begins with a thorough evaluation. Specialists use diagnostic tools to distinguish between hormonal causes and structural factors that may affect conception. This insight is essential for designing a targeted, individualized approach to support your reproductive goals.

Understanding the Two Main Categories of Infertility Causes

Infertility can stem from various factors, broadly categorized into hormonal (functional) and structural causes:

• Hormonal (Functional) Causes: These involve disruptions in the endocrine system, affecting ovulation, hormone production, and overall reproductive function. Conditions like polycystic ovary syndrome (PCOS), thyroid disorders, and pituitary gland abnormalities fall into this category.
• Structural Causes: These refer to physical issues within the reproductive organs, such as blocked fallopian tubes, uterine fibroids, or endometriosis, which can hinder the passage of eggs or sperm.

Diagnostic Approaches for Hormonal Causes

To assess hormonal factors, specialists may recommend:

• Blood Tests: Measuring levels of hormones like follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, thyroid-stimulating hormone (TSH), and prolactin to evaluate ovarian reserve and endocrine function.
• Ultrasound Imaging: Transvaginal ultrasound can detect ovarian cysts, polycystic ovaries, or uterine abnormalities, providing insight into structural and functional aspects of the reproductive system.
• Ovulation Monitoring: Tracking ovulation through basal body temperature charting or ovulation predictor kits helps determine if ovulation is occurring regularly.
• Additional Hormonal Assessments: Tests for cortisol, insulin, and androgens may be conducted to identify conditions like adrenal disorders or insulin resistance, which can impact fertility.

Diagnostic Approaches for Structural Causes

When structural issues are suspected, the following evaluations are commonly performed:

• Hysterosalpingography (HSG): An X-ray procedure that examines the fallopian tubes and uterine cavity to identify blockages or abnormalities.
• Sonohysterography: An ultrasound technique enhanced with saline infusion to better visualize the uterine lining and detect abnormalities like polyps or fibroids.
• Hysteroscopy: A minimally invasive procedure allowing direct visualization of the uterine cavity to identify and sometimes treat issues like adhesions, fibroids, or polyps.
• Laparoscopy: A surgical procedure used to view the pelvic organs and diagnose conditions such as endometriosis, adhesions, or tubal blockages.

Integrated Approach to Diagnosis

Fertility specialists often combine various diagnostic tools to obtain a comprehensive understanding of the factors affecting fertility. For instance, if a woman presents with irregular menstrual cycles, blood tests may be conducted to assess hormone levels, while imaging studies like ultrasound or HSG can evaluate the structural integrity of the reproductive organs.

When to Seek Evaluation

According to the American Society for Reproductive Medicine (ASRM), couples should consider seeking fertility evaluation if:

• The woman is under 35 years old and has been trying to conceive for over 12 months without success.
• The woman is 35 years or older and has been trying to conceive for over 6 months without success.
• There are known reproductive health issues, such as irregular periods, pelvic pain, or a history of pelvic infections.

Early evaluation can lead to timely interventions, improving the chances of conception.

Next Steps

If you're experiencing difficulties in conceiving, it's important to consult with a fertility specialist who can guide you through the diagnostic process. At URA, we offer comprehensive fertility evaluations to identify the underlying causes of infertility and develop a personalized treatment plan to support your journey toward parenthood.