The diagnosis of infertility follows the path from basic to invasive. The diagnosis of infertility is typically considered if a couple has been actively trying to get pregnant for a year or more and has been unsuccessful.
Tests for fertility
When a couple consults with a physician seeking help with fertility issues, the physician will typically start with a fertility evaluation which may consist of:
- A physical exam of both partners * Inquiry into past health issues, such as a miscarriage or pelvic inflammatory disease * Inquiry into lifestyle habits around exercise and alcohol and drug use * Tests for semen quality to determine sperm count. These tests look at the number, shape, and movement of the sperm * Tests for both partners to determine hormone balances. Hormone imbalances can be indicative of ovulation or sperm problems that can be treated. These tests may include: * Luteinizing hormone (LH). Abnormal LH levels can be a sign of female ovulation problems or male testosterone production problems. * Progesterone. Low progesterone levels can be a sign of ovulation problems. * Follicle-stimulating hormone (FSH), sometimes followed by a more specific clomiphene challenge test of the egg supply. High FSH levels may be a sign of low egg supply, or ovarian reserve; low FSH levels can prevent ovulation or, in men, sperm production. * Thyroid-stimulating hormone (TSH). Abnormal thyroid function can affect the menstrual cycle and ovulation. * Prolactin. High prolactin can be a sign of a pituitary problem, which can affect ovulation. * Testosterone. Low testosterone in men can cause sperm production problems. High levels in women can cause irregular menstrual periods.
Tests for Fallopian Tubes
To determine if a woman’s fallopian tubes have been damaged by previous STD’s or other past illnesses, the doctor may use
- Laparoscopy: a surgical procedure called laparoscopy in which tiny cameras are inserted through a small cut in the abdomen to view the reproductive organs in more detail. The physician will be looking for scarring or blockages that may be impacting a woman’s ability to get pregnant. * Hystersalpingography: a test in which a special dye is inserted through the vagina in to the uterus. Then, an x-ray can show whether the dye moved normally through the uterus into the fallopian tubes. A doctor can determine if a blockage is preventing eggs from moving from the fallopian tube to the uterus OR preventing the sperm from reaching the egg.
In order to establish that a woman is ovulating, a doctor may recommend:
charting basal body temperature.
- Using a Home Ovulation Test kit to test luteinizing hormone (LH) levels in urine to confirm that ovulation occurs within 12 to 36 hours after the temperature increase registered in charting the basal body temperature