CHAPTER 14 Women’s Health^509
tract of the woman is at issue. Primary infertility is when a woman has never had
a pregnancy; secondary is when it occurs in a woman who has had one or more
pregnancies.
WHAT WENT WRONG?
At fault may be decreased secretion of hormones from the anterior pituitary, failure
to ovulate, endometriosis, or past infections causing blockage of the reproductive
tract. Structural problems (blocked fallopian tubes, or anovulation), poor sperm
motility and/or count, or multifactorial problems can cause infertility. Prior expo-
sure to radiation, medications, exercise frequency, and menstrual cycle and length
need to be evaluated.
PROGNOSIS
Infertility affects about 15 percent or more of couples.
HALLMARK SIGNS AND SYMPTOMS
- Inability to achieve conception
INTERPRETING TEST RESULTS
- Semen analysis.
- Menstrual diary.
- Sonogram to view endometrial anatomy.
- Endometrial biopsy to check on hormone status and to determine if
the lining is able to support a fertilized ovum, and if leiomyomas are
present. - Labwork: hormone levels—progesterone, LH, FSH, TSH to check on nor-
mal uterine, ovarian, pituitary, and thyroid function. - Hysterosalpingogram to view uterus, fallopian tubes.
- Postcoital test—cervix is checked for patency and whether the mucous is
thin enough for sperm to penetrate.