The reality is that in the United States alone about 10 per cent of all couples trying to conceive will have problems with infertility.
It’s important that both women and men are tested to see what the causes of their infertility may be. If you and your partner have been unable to conceive after about one year of trying, it may be time to seek diagnosis and treatment.
There are a variety of different tests that your doctor may order for you. The more you know about the different types of tests that are available the better able you’ll be to cope.
First Step of Infertility Diagnosis
Before you undergo a lot of invasive testing your doctor will start out with the basics. A complete medical history will be taken including a discussion about your current lifestyle and your sexual habits.
This includes information about the following:
- History of your menstrual cycle.
- History of prior pregnancies.
- Any birth control that you’re now using or have used in the past.
- Any past surgeries that you’ve had.
- Any medications that you’re now using or have used in the past.
- A discussion about your living and work conditions.
You’ll also be given a physical examination. Your doctor will examine your breasts and give you a pelvic exam that includes a pap smear.
It’s important to start with the basics and check your overall general health before further infertility testing is done.
Your Fertility and Ovulation
Most likely if you’ve been trying for a few months to get pregnant then you’ve been tracking your menstrual and ovulation cycles using an ovulation predictor kit.
This will give your fertility specialist a good idea about whether or not you’re ovulating. One of the first questions that will usually be asked when you’re seeing a specialist is about ovulation.
There are several different types of tests that evaluate ovulation:
- Ovulation Testing: Your doctor will need to confirm that you’re ovulating. This is done using BBT (basal body temperature) charting, blood tests, ultrasound, and ovulation predictor kits.
- Ovarian Testing: Ovarian function tests are used to determine if your hormones are functioning correctly when you’re ovulating. These types of tests include blood tests to measure inhibin B levels, an ultrasound to ensure that ovulation has happened, and a Day 3 Estradiol test (to measure estrogen levels). You may also be given a test to determine FSH (follicle stimulating hormone) levels.
- Luteal Phase Testing: This test measures your progesterone levels and determines if your uterus is able to receive a fertilized egg for implantation.
- Cervical Mucus Testing: A PCT (postcoital test) is done to determine if your partner’s sperm is able to move through and survive the cervical mucus.
- Ultrasound: An ultrasound is used to measure the thickness of the endometrium (the lining of the uterus) as well as check on the general condition of your ovaries and uterus.
If the above tests aren’t able to provide your doctor with some answers about why you’re not conceiving, there are still further tests that can be ordered.
The aim of these tests is to start with the obvious and most common factors of female infertility and then move on to less common causes.
Invasive Infertility Testing
The following infertility tests are more invasive than others. However, if your fertility specialist is unable to find a reason for less invasive tests about why you’re not conceiving then these tests may become necessary:
- Hysterosalpingogram (HSG): In this test, an x-ray is taken of your uterus and fallopian tubes. A special dye will then be injected into your cervix and through to the uterus and fallopian tubes to determine if there are any blockages or other problems preventing your partner’s sperm from fertilizing your egg.
- Laparoscopy: This test is done using general anaesthesia. A thin fiber optic telescope will be carefully inserted through your abdomen so the surgeon can look at your ovaries, fallopian tubes, and uterus. If any abnormalities are found, the surgeon may correct them at this time. This includes the removal of adhesions, scar tissue, and endometriosis.
- Hysteroscopy: If the HSG test reveals any possibility of irregularities a hysteroscopy may be performed to look for any growths or other abnormalities in the uterus.
- Endometrial Biopsy: During this procedure, a tiny amount of tissue will be scraped from the endometrium to measure its thickness. This test is performed right before you menstruate. The thickness of the endometrium needs to be adequate for implantation of the fertilized egg.
The numerous tests that can be done to determine female infertility may seem daunting and frightening. The causes of infertility are both varied and many.
In some cases, the cause of your inability to get pregnant may be easy to diagnose and treat. In other cases, there may be a combination of factors that need to be addressed.
A close examination of all the factors that have to do with the female reproductive system is necessary for your doctor to make a correct diagnosis of your fertility problems.