Female Infertility: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; furthermore:
    • Inspection (viewing).
      • Skin and mucous membranes [objective evaluation of distribution/quantity of hair: increased hairiness of terminal hair (long hair) in women according to male distribution pattern (hirsutism)?; seborrhea (oily skin)?, acne?; alopecia androgenitica (androgenic balding)?]
      • Abdominal wall and inguinal region (groin area).
  • Gynecological examination
    • Inspection
      • Vulva (external, primary female sexual organs).
      • Vagina (vagina)
      • Cervix uteri (cervix), or portio (cervix; transition from the cervix (cervix uteri) to the vagina (vagina)), taking a Pap smear (for early detection of cervical cancer).
    • Palpation (bimanual; palpation with both hands) of the internal genital organs.
      • Cervix uteri (cervix).
      • Uterus (uterus) [Normal: anteflexed/angled anteriorly, normal size, no tenderness].
      • Adnexa (appendages of the uterus, i.e., the ovary (ovary) and uterine tubule (fallopian tube)) [Normal: free]
      • Parametria (pelvic connective tissue in front of the cervix to the urinary bladder and on both sides to the lateral pelvic wall) [Normal: free].
      • Pelvic walls [Normal: free]
      • Douglas space (pocket-like bulge of the peritoneum (abdominal wall) between the rectum (rectum) at the back and the uterus (uterus) at the front) [Normal: clear].
    • Inspection of the mammae (breasts), right and left; the nipple (nipple), right and left, and the skin [Normal: unremarkable; if necessary, increased hairiness of the terminal hairs (long hairs) of the woman according to male distribution pattern in the upper sternum area, around the areolae]
    • Palpation of the mammae, the two supraclavicular pits (upper clavicle pits) and axillae (axillae) [Normal: unremarkable].
  • Health check – to determine individual health risks.
  • Nutritional analysis – to determine the nutritional situation including the determination of the individual micronutrient additional requirements (vital substances).

In square brackets [ ] refers to possible pathological (pathological) physical findings.