Pelvic Factor

Normal Events

Pelvic Factor Detection

Pelvic Abnormalities

Clinical Evaluation

Treatment Options

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Dr Eric Daiter is a nationally recognized expert in Reproductive Endocrinology and Infertility who has proudly served patients at his office in New Jersey for 20 years. If you have questions or you just want to find a caring infertility specialist, Dr Eric Daiter would be happy to help you (in the office or on the telephone). It is easy, just call us at 908 226 0250 to set up an appointment (leave a message with your name and number if we are unable to get to the phone and someone will call you back).


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The semen analysis is a good screening test for major male factor abnormalities, including those involving the (male) outflow tract. If azoospermia (a complete absence of sperm in the semen) is detected then an organized and cost considerate diagnostic plan should be initiated in order to identify men with potentially treatable (mostly pre or post testicular) causes. If the semen analysis suggests an infection then specific treatments (such as antibiotics) can be initiated. When an obstruction is detected along the male outflow tract, good quality sperm can often be retrieved from the site of obstruction (or the epididymis). Occasionally, the obstruction can be surgically repaired with good restoration of function.

Diagnostic tests for female pelvic factors include (but are not limited to) the pelvic examination, postcoital test, hysterosalpingogram, and pelvic evaluation (laparoscopy and hysteroscopy).

Soon after a couple initiates care in my office I suggest an evaluation that looks for a pelvic factor.

I perform the (female) pelvic examination. Some anatomic abnormalities involving the vagina and cervix can be identified simply on inspection.

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I usually recommend a postcoital test shortly prior to (expected) ovulation to identify significant sperm mucus interaction abnormalities. It is clear that sperm must be comfortable within the cervical mucus for optimal fertility rates. If a hostile relationship between the sperm and the mucus is identified then I often suggest intrauterine inseminations (to place the motile sperm above the cervix and its mucus) timed around ovulation.

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I also recommend a hysterosalpingogram early in the diagnostic testing to identify any abnormalities within the uterine cavity and determine (fallopian) tubal patency. Many completely asymptomatic women with no particular risk factors for pelvic abnormalities do have a significant treatable pelvic factor that can be identified on hysterosalpingography.

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An endometrial biopsy is sometimes suggested as a routine diagnostic test during an infertility evaluation. I generally do not recommend the endometrial biopsy to my infertility patients during their initial (basic) evaluation unless I strongly suspect a luteal phase (progesterone) insufficiency problem.

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Endometriosis and pelvic adhesions may result in reduced reproductive success and are not usually identifiable without direct visualization of the pelvis. The tremendous (technical) advances in operative laparoscopy and operative hysteroscopy have (recently) revolutionized the ability of (trained) surgeons to identify and treat most major abnormalities with minimally invasive surgery. Pelvic evaluation plays a central role in my diagnostic evaluation, even though I typically reserve surgical evaluation to follow identification and treatment of all nonsurgical factors.

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