Evaluation of the Infertile Couple
FERTILIZATION is an exceedingly complex process involving many fundamental questions of cellular biology. Each year our knowledge increases and with this our understanding of the biochemical aspect of reproduction. The entire mechanism is related to emotional as well as physical health. Hormonal production is dependent upon stimuli from the cerebral cortex, the hypothalamus, the pituitary, the adrenals, the thyroid, and the ovaries. Only recently has the amazing interrelationship of these hormones been appreciated.
Study of the infertile couple must show whether or not male and female gametes are produced and whether or not the passageways needed for their union are patent. It must also show whether or not physiologic and biochemical functions of the female reproductive tract are favorable to migration of spermatozoa, to transfer of the ovum to the fallopian tube, to fertilization of the ovum, and to growth of the resulting embryo.
For fertility, there must be an orderly sequence of biochemical changes and coordinated muscular activity in the female reproductive tract. Such an environment is dependent on general health, normal functioning of many endocrine glands, and the ability of the reproductive system to respond to changing biochemical stimuli. Stress, caused by illness, fear, or frustration, has a significant effect on the ability of the reproductive tract to function normally.
The purpose of this paper is to discuss the procedure we use at the Cleveland Clinic to study the infertile couple, to show how the results are used to evaluate the causes of infertility, and to point out . . .