Unexplained or Unexplored Infertility? By Nicole Kerr, ND, LAc
T
he inability to become pregnant or carry a pregnancy to term is caused by a myriad of medical conditions and other contributing factors. Therefore, each case of infertility needs to be uniquely reviewed to identify if there is a single cause, several causes, or no identifiable cause. Both partners should be evaluated, as in the U.S. about 9% of men and 11% of women in their reproductive age experience fertility problems. Evaluating the cause of infertility in only the female partner can waste months of valuable time and result in the use of inappropriate, unnecessary, and often expensive procedures while during this time, the male partner could be identifying and correcting his fertility status as well. Even if there is an identifiable cause in the female, the male partner should still be evaluated.
WHO Semen Analysis Reference Ranges PARAMETER
NORMAL
Semen volume
>1.5 mL
pH
7.2 or more
Sperm concentration
15 million/mL or more
Total sperm number
39 million or more
Total motility
>32% progressive motile, >40% progressive and nonprogressive
Vitality
58% or more live spermatozoa
Sperm morphology
4% or more
Male partner standard evaluations include:
Female partner standard evaluations include:
Infertility Evaluations of Both Partners
• History: prior paternity; undescended testicles at birth; trauma to testicles; medical and surgical review; sexual dysfunction; medication, alcohol, tobacco, and illicit drug use.
• History: prior pregnancies and outcome; medical and surgical review; sexual dysfunction; medication, alcohol, tobacco, and illicit drug use; menstrual disturbances.
The following standard evaluations are performed when infertility concerns arise.
• Examination: testicular abnormalities; varicocele; absences of vas deferens.
• Ovulation: urine luteinizing hormone ovulation predictor kits; mid-luteal serum progesterone.
• Semen analysis: See chart above.
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