The Infertility Workup: Key Insights and Options at AHN's Center for Reproductive Medicine

Infertility affects 10–15% of couples in the U.S., yet it remains under-recognized in many general women’s health settings.* The AHN Center for Reproductive Medicine under AHN’s Women’s Institute is working to close this gap by standardizing early evaluation, improving access to specialty diagnostics, and guiding providers on when to refer.

Establishing a baseline through history and examination

Evaluation is recommended after:

• 12 months of trying to conceive for patients under 35
• Six months for patients 35–40
• Immediate referral for patients over 40 or with known reproductive risk factors (irregular menstrual cycles, endometriosis)

At AHN’s Center for Reproductive Medicine, infertility assessments begin with a focused medical, surgical, obstetric, and gynecologic history. Clinicians also evaluate lifestyle variables known to affect fertility, such as tobacco and alcohol use, diet, exercise, and stress.

Physical exam findings relevant to fertility include thyroid abnormalities, elevated BMI, and signs of hormonal dysfunction, such as acne, hirsutism, or galactorrhea.

“The baseline assessment is where we often catch early clues — irregular cycles, signs of endocrine dysfunction, or risk factors that warrant immediate specialty referral,” said Terrence Lewis, MD, PhD, FACOG, medical director and specialist in reproductive endocrinology and infertility at AHN Center for Reproductive Medicine. “These findings help us prioritize the diagnostic pathway and prevent patients from losing time.”

Evaluating ovarian reserve and reproductive anatomy

AHN’s Center for Reproductive Medicine offers a comprehensive diagnostic panel, including:

• Ovarian reserve testing: AMH, AFC, FSH, estradiol.
• Anatomic imaging: HSG, saline infusion sonohysterogram, and hysteroscopy.
• Endocrine evaluation: Screening for PCOS, thyroid dysfunction, and related disorders.

The center also provides additional expertise in diagnosing and managing fibroids, endometriosis, polyps, and other structural abnormalities.

Considering male factors

Male factors contribute to roughly one-third of infertility cases.** Evaluation of male reproductive function at AHN includes:

• Medical history (including chronic conditions or hormonal disorders)
• Surgical history (particularly genital or urologic procedures)
• Prior reproductive history

Following initial assessment, a semen analysis is performed after 48–72 hours of abstinence to assess sperm count, motility, and morphology. A total motile count greater than 20 million is generally considered normal. Early identification of male sperm abnormalities allows for timely referral and helps our specialists guide couples toward the most appropriate interventions.

“Parallel evaluation of both partners prevents delays,” said Dr. Lewis. “This helps us develop a treatment plan that reflects the full clinical picture.”

How to refer

OB-GYNs referring to AHN’s Center for Reproductive Medicine give patients access to:

• Rapid scheduling for diagnostic testing
• Integrated evaluation for both partners
• Early counseling on treatment pathways
• Access to advanced reproductive technologies

To refer a patient, call 412-847-1166 or submit an online referral via MyChart.