Fertility Tests

What are infertility tests?

Infertility tests are done to help find out why a woman cannot become pregnant. The tests help find whether the problem is withthe man, the woman, or both. Tests usually include a physical examination, semen analysis, blood tests, and special procedures.

What tests are done first?

Tests to find the cause of infertility
Test Description
Both partners: Medical history Your doctor will ask questions about your sex life, your birth control methods, any sexually transmitted infections (STIs), medicine use, and the use of caffeine, tobacco, alcohol, or illegal drugs. Your menstrual cycle and exercise patterns will be checked. If STIs are suspected, more tests may be done.
Both partners: Physical examination A complete physical examination of both you and your partner is done to check your health.

  • A woman’s physical examination usually includes a pelvic examination and Pap test.
    Pelvic Examination
    Pap Test
  • A man’s physical examination usually includes a testicular examination. Not all fertility doctors will do a physical examination of the man. If there are problems with the semen, the doctor may refer the male partner to a urologist.
    Testicular Examination
Both partners: Blood or urine tests
  • Luteinizing hormone (LH) and progesterone tests may be done during a woman’s menstrual cycle to help see whether she is ovulating. LH may be checked in a man to see whether he has a pituitary gland problem.
    Luteinizing Hormone (LH)
    Progesterone
  • Thyroid function tests may be done to check for thyroid hormone problems that may be preventing ovulation.
    Thyroid Hormone Tests
    Thyroid-Stimulating Hormone (TSH)
  • Prolactin is a hormone made by the pituitary gland. It may be checked if a woman has menstrual cycle or ovulation problems.
    Prolactin
  • The anti-mullerian hormone test is a blood test that is sometimes used to check a woman’s egg supply (ovarian reserve). It may be used for women who are considering in vitro fertilization (IVF). Anti-mullerian levels go down as a woman’s egg supply decreases, which usually happens with age.
  • In some cases, follicle-stimulating hormone (FSH) may be used to check a woman’s egg supply (ovarian reserve). FSH testing may also be used for men with a very low number of sperm to try to find out the source of the problem.
    Follicle-Stimulating Hormone
  • A testosterone test may be used to see whether a problem with the testicles or pituitary gland is preventing a man from being able to father a child. A low amount of testosterone can lead to low sperm counts.
    Testosterone
  • Tests for sexually transmitted infections (STIs) may be done. These may include urine samples or samples from the cervix or urethra.
Male partner: Semen analysis A semen analysis checks the number of sperm (sperm count), the number of sperm that look normal, the number of sperm that can move normally, the number of white blood cells in the semen, and how much semen is made.

Semen Analysis
Female partner: Home test Home LH urine test kits can be used to see when ovulation occurs. Sometimes a woman’s basal body temperature (BBT) is also checked at the same time.

What if the first tests do not find a cause?

If the first tests do not find a cause for infertility, the woman may have one or more of the following tests.

Tests for women to find the cause of infertility
Test Description
Pelvic ultrasound A pelvic ultrasound looks at the size and structure of the uterus and both ovaries. It can check the condition and size of the ovaries during treatment for infertility. It can also be used to check a woman’s egg supply (ovarian reserve). This is done by counting the number of follicles in both ovaries during a certain phase of the menstrual cycle (antral follicle count).

Pelvic Ultrasound
Hysterosalpingogram A hysterosalpingogram is an X-ray test that looks at the inside of the uterus and the fallopian tubes. The pictures can show a blockage of the fallopian tubes that would prevent an egg from reaching the uterus or prevent sperm from moving into a fallopian tube to join (fertilize) an egg. This test may also see problems on the inside of the uterus that might prevent a fertilized egg from attaching (implanting) to it.

Hysterosalpingogram
Sonohysterogram A sonohysterogram is an ultrasound test that uses saline and ultrasound to look at the female reproductive organs.

Sonohysterogram
Laparoscopy Laparoscopy is a procedure to look at a woman’s pelvic organs (uterus, fallopian tubes, and ovaries) using a thin, lighted scope that is put through a small cut (incision) in the belly. This procedure is used to find cysts, scar tissue (adhesions), fibroids, and infections that can affect fertility. Laparoscopy can also be used to treat conditions, such asendometriosis. Laparoscopy is usually done with general anesthesia.

Laparoscopy

What other tests may be done?

If a hysterosalpingogram, laparoscopy, or endometrial biopsy does not find a reason for your infertility, or if your infertility treatment has been unsuccessful, one or more of the following tests are sometimes used.

Other tests to find the cause of infertility
Test name Description
Both partners: Antibody blood tests Antibody blood tests may be done to find antisperm antibodies in blood, semen, or vaginal fluids. Doctors question the value of antibody tests for finding the cause of infertility.

Antisperm Antibody Test
Both partners: Karyotype (chromosome analysis) or genetic test
  • Karyotyping is a blood test that looks for problems in the genetic material (chromosomes) in your cells. Some genetic problems make it hard to become pregnant or cause miscarriages.
    Karyotype Test
  • Genetic tests may be done to help find the cause of infertility.
    Genetic Test
Male partner: Ultrasound Ultrasound uses sound waves to make a picture of structures inside the body. It may be done to see whether a problem in the testicles is causing a problem with the sperm.

Testicular Ultrasound
Male partner: Testicular biopsy In rare cases, when men have no sperm in their semen, a testicular biopsy may be done to check the sperm in the man’s testicles.

Testicular Biopsy
Female partner: Hysteroscopy Hysteroscopy is a procedure that looks at the lining of the uterus using a thin, lighted scope that is put through the vagina and cervix into the uterus. Hysteroscopy is used to find problems in the uterine lining. Sometimes your doctor can use small tools during the procedure to take out growths or take samples of tissue (biopsy) or open a blocked fallopian tube.

Hysteroscopy

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