Infertility physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor(s)-in-Chief: Sanjana Nethagani, M.B.B.S.[3]

Physical examination plays an important role in detecting infertility. A detailed history and physical, along with imaging and blood tests can identify the cause of infertility in most cases

• Infertility testing involves a complete medical history and physical examination of both partners.

• Blood and imaging tests will be done^[1]

• In women, this may include:

• Blood tests to check hormone levels, including progesterone and follicle stimulating hormone^[2]
• Checking body temperature first thing in the morning to check if the ovaries are releasing eggs
• FSH and clomid challenge test
• Hysterosalpingography (HSG)
• Pelvic ultrasound
• Laparoscopy
• Luteinizing hormone urine test (ovulation prediction)
• Thyroid function tests

• Tests in men may include:

• Sperm testing
• Testicular biopsy (rarely done)

Some important findings in physical exam might be

• Exophthalmos might indicate hyperthyroidism
• Webbed neck is seen in Turner’s syndrome
• Epicanthal folds in eyes and low set ears are seen in Down’s syndrome
• Neck swellings in thyroid pathology

• Thorough breast exam might reveal swellings or nipple discharge
• Any palpable swellings in the abdomen

• Pattern of distribution of pelvic hair
• If there is presence of any clitoral enlargement
• Any external signs of sexually transmitted infections
• Cervical motion tenderness
• Presence of fibroids
• Septate vagina

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