Infertility Evaluation at our Houston OBGYN Clinic

March 30, 2022
Lisa Otey, MD

Statistics show that up to one in ten of US couples are infertile; a couple may be considered to be infertile if the woman has not become pregnant after a period of a year or so of sexual activity without contraception. This leads many couples to an infertility evaluation. Factors such as the age of both partners is also taken into consideration. You need an OBGYN of Houston to evaluate you and your husband.

If you have not been able to conceive and feel that the length of time you have been trying is unusually long, you may wish to undergo an infertility evaluation. There are several methods of treatment available; this article will attempt to outline what is involved in infertility evaluation, the tests performed by the trusted OB GYN of Houston to check for infertility, and the options for treatment that would be available to you should the need arise.


Getting pregnant starts with ovulation; half-way through your monthly cycle—fourteen days after the initial day of your previous period—an egg is released from the ovary and must be fertilized within the next twenty-four hours. This is the perfect time to have sex.

If the sperm which is carried in the man’s ejaculate successfully travels from the vagina, through the cervix and into the fallopian tubes, the sperm may join with the egg and fertilization may occur.

After being fertilized, the egg must travel down into the uterus and attach to the wall—if there is something preventing any of these stages of the process happening, it may result in a couple being infertile. An infertility evaluation would help uncover this type of situation.

Reasons for infertility

There may be several causes of infertility, two-thirds are related to the woman, a fifth to the man, while in 15% of cases, no apparent attributing factor can be found. The ages of each partner affect the probability of conception; in young couples, there is a one-in-five chance that the woman will conceive during her cycle, but this figure decreases with age and especially so after the woman reaches her mid-thirties. In men, fertility also decreases with age but at a much slower rate.

Here is a summary of the most important factors affecting fertility:

  • Sperm count and health
  • Hormone levels (both male and female)
  • STDs—infection or resultant scarring
  • Erratic ovulation
  • Obstructions in the cervix or fallopian tubes
  • Poor nutrition and/or obesity

In addition to these fundamental factors, it has also been established that exposure to the drug diethylstilbestrol (DES) can be a contributing factor to infertility.


The ages of the couple and the time period you have been trying to get pregnant will be considered before an infertility evaluation begins. Treatment will be undertaken together and will generally involve having a physical examination, analysis of your medical history and a semen and ovulation assessment performed by the Houston OBGYN group you trust. Additionally, it might be necessary to verify that the woman’s internal anatomy is clear and to discuss the frequency and timing of your sexual activity.

The entire infertility evaluation procedure can be completed over just a few menstrual cycles and you may find that the cost can be met through your medical insurance plan.

Tests for men

The most important test for the man is an analysis of his semen. You will be asked to provide a sample, either at home or in the laboratory, and your doctor will provide you with instructions. The sample will be examined to determine the number and form of the sperm, and also their movement and health.

It may be necessary to carry out tests relating to the urinary tract, for which you will need to visit a urologist.

Tests for women

Background information relating to the menstrual cycle, any history of pregnancy or STDs, and the use of contraceptive methods will be gathered. You may also be required to provide a blood sample or undergo a Pap test.

Urine analysis:
A kit will be provided for the woman to do this test at home. Measurement of the LH (luteinizing hormone) levels will reveal whether or not ovulation is occurring.

Basal temperature:
This is another test during the infertility evaluation which is performed at home. The woman takes her temperature every morning when she wakes, for two or three cycles, and records the data. When ovulating, a woman’s temperature rises slightly and the temperature chart will show if this is actually happening.

HSG (hysterosalpingography):
Immediately after a period, dye is injected into the uterus through a tiny tube and an X-ray taken. The dye reveals the outline of the fallopian tubes and uterus—any spillage indicates open tubes.

Transvaginal ultrasound:
A small transducer is lubricated and inserted into the vagina and images are produced on a screen of the internal anatomy.

A tiny telescope allows the physician to examine the inside of the uterus which may be first injected with a gas or liquid. Minor irregularities may be corrected during this procedure and information gathered to determine whether or not further procedures may be necessary.

A small incision below the naval allows the insertion of an optical device though which the doctor can examine the ovaries, tubes and uterus exterior. Fluid is introduced to check that the tubes are open and investigation for endometriosis and other pelvic conditions can be undertaken.


The causes identified by the infertility evaluation will determine the treatment which may involve medication for ovulation induction or surgery for infertility, new techniques to facilitate reproduction, and even basic lifestyle changes. You may want to consider an infertility evaluation if you have been trying for a baby for between six and twelve months without success.

Our Houston OBGYN group offers the kind of infertility evaluation you need. Contact us by phone or web to make a same day appointment to discuss your specific needs if you need a Houston OBGYN.  We’re always happy to hear from you!