Female Fertility Testing

Because infertility can have a dramatic impact on your life, it is an alarming concern for couples.

Infertility does not always look so grim. Even though a person can be declared infertile after trying for one year to conceive, it may still not necessarily mean the same thing after 12 months. One recent study conducted by the National Institute of Environmental Health Sciences found that the majority of women up to age 39 who didn't become pregnant in their first year did become pregnant in their second year -- without any medical assistance. For women between ages 27 and 34, only 6% were unable to conceive in their second year. And for 35- to 39-year-old women, only 9% were unable to conceive in their second year -- provided their partner was under 40.

Even if your attempts to get pregnant have been unsuccessful for over a year now, it does not necessarily mean that you are incapable of getting pregnant. Avoid the urge to rush to expensive infertility treatment before you are ready.

Go to the Infertility Doctors

A doctor is the best option if you have concerns about infertility. The doctor will talk with your partner and discuss your health . While you might find the questioning awkward and embarrassing at times, this is the most effective way to determine what may be the cause of your problems. A lot of times infertility results from a combination or a few problems in one partner. This makes it important to do a comprehensive examination.

Be sure to understand what the infertility test costs are before visiting a specialist. Make sure your insurance covers them.

Most likely, your doctor will ask both of you about the following:

Your doctor will also want to ask about a woman's gynecologic history and ask you:

If you've ever been to a fertility specialist about your fertility issues, bring any fertility-related records, X-rays, and sonograms.

Analyses of blood and sperm

Once the interview is out of the way, your infertility workup will likely begin with a physical exam and blood tests to check levels of female hormones, thyroid hormones, prolactin, and male hormones, as well as for HIV and hepatitis.

An additional part of the physical exam could include a pelvic inspection to rule out chlyamydia and gonorrhea.

A complete semen analysis may be required for the male partner to check for possible genital infection. A complete semen test will be performed by your doctor on the male partner in order to determine the size, shape and motility.

Your doctor may schedule other blood tests around the woman's menstrual cycle . On day 2 or 3, you will need to have tests done for FSH and LH. Your luteinizing hormone levels rise in the middle stage of your cycle, in the mid-luteal period. This means that you might need additional testing and another seven days after you start ovulating. Your doctor will test your estrogen and progesterone levels after you have ovulated. These levels can be compared with those taken the day before.

Others Tests and Procedures You may be asked by your doctor to chart your basal body temperatures in order to determine if you are ovulating. Although BBT charts have been around for a long time, experts do not believe it to be as reliable as other ovulation tests.

Postcoital test. For this test, you will need to intercourse for several hours before visiting your doctor. Then, you'll have to take a microscopic sample of the cervical mucus from your doctor. This test is used to determine the viability and interaction of the sperm with cervical mucus.

Ultrasound exam of the transvaginal (or pelvic) area. An ultrasound may be recommended by your doctor to assess the health of the uterus or ovaries. The doctor will often be able to determine if the follicles are functioning normally. Thus, the ultrasound is often performed 15 days before a woman's expected menstrual period.

Hysterosalpinogram. A hysterosalpinogram (also known as an HSG, "tubogram") may be recommended by your doctor. This procedure involves taking a series or X-rays to examine your fallopian tube after liquid dye has been instilled into your uterus via your cervix. HSG is a tool that can diagnose uterine defects and fallopian tube obstructions. Because the liquid dye can't penetrate into the blocked tubes, it should be obvious on X-ray. A HSG appointment is typically scheduled in the six- to thirteenth days of your cycle.

Hysteroscopy. A hysteroscopy may be ordered if the HSG is showing signs of trouble. A thin, telescope-like device is introduced through the cervical cavity into the uterus. This allows the doctor to view and photograph any problems.

Laparoscopy. Laparoscopy. A laparoscope, which is used to examine the abdominal for scarring and endometrium, will be inserted through an incision. You will need to be under general anesthesia for this procedure, which is more involved than the HSG.

Endometrial biopsies. To determine if your uterine lining is normal and to allow embryos to be implanted, your doctor might want to perform an endometrial biopsy. An endometrial biopsy is when a doctor takes a sample from your endometrium. The cathether, which passes through the vaginal and cervix, then goes into the uterus. Lab analysis of the sample takes place. This procedure can be uncomfortable, so painkillers are prescribed beforehand. Not all women undergo all these tests. You will be able to choose the most suitable for you. About 85% couples will be able to identify the reason they are having difficulty getting pregnant after testing.