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Infertility tests are
done to help find out why a woman cannot become pregnant. The tests help find
whether the problem is with the man, the woman, or both. Tests usually include
a physical exam,
semen analysis, blood tests, and special procedures.
Before you have infertility
fertility awareness methods to find the best time to
become pregnant. A woman is most fertile during
ovulation and 1 to 2 days before ovulation. Some
couples find that they have been missing the most fertile days when trying to
become pregnant. A woman should keep a record of her menstrual cycle and when
she ovulates. This record will help your doctor if you decide to have
To learn more, see the topic Fertility Awareness.
tests for you or your partner if:
Some tests, such as
a semen analysis, physical exam, and blood tests, do not cause pain. But
some procedures, such as an endometrial
laparoscopy, or a
hysterosalpingogram, may cause some pain.
Infertility tests can
cost a lot and cause stress. You and your partner will need to keep track of
the frequency of sexual intercourse and talk about this with your
Before you have infertility tests, talk with your partner
about how much testing you want to do. Sometimes you may not find out what
causes infertility even after many tests. So it is important to know how many
tests you want to try.
tests, such as semen analysis, blood tests, or an
ultrasound, do not usually cause any problems. Other
tests that are medical procedures, such as
hysteroscopy or laparoscopy, have a higher chance of
problems after the test.
tests, including the physical exam, medical history, and blood tests,
can be done in your doctor's office or clinic by an
reproductive endocrinologist. Your
family medicine physician may do some of the first
tests. Tests on a man may be done by a
urologist. Some medical procedures are done in an
Infertility tests may find what is causing the problem and you can
sometimes be treated during the tests. For example, a blocked
fallopian tube may be opened during a
Sometimes tests cannot find the cause of
infertility. And not all infertility problems can be treated. Infertility in men
is often less successfully treated than infertility in women. But you may still
be able to become pregnant using
assisted reproductive technology, which can treat male
or female problems.
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
Both partners: Physical
A complete physical exam of both you
and your partner is done to check your health.
Both partners: Blood or urine
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
Female partner: Postcoital test
The postcoital test checks a woman's
cervical mucus after sex to see whether sperm are alive and able to move
normally through the mucus. This test must be done the day before or the day of
ovulation. Many doctors question the value of the postcoital test to check for
infertility. It is not done very often.
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
the first tests do not find a cause for infertility, the woman may have one or
more of the following tests.
A pelvic ultrasound looks at the size and
structure of the
uterus and both
ovaries. It can also check the condition and size of
the ovaries during treatment for infertility.
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.
A sonohysterogram is an ultrasound test that
uses saline and ultrasound to look at the female reproductive
An endometrial biopsy is done to take out a
small piece of the uterine lining (endometrium) to
see whether the lining has normal changes during the menstrual cycle.
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 as
endometriosis. Laparoscopy is usually done with
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.
Both partners: Antibody blood
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.
Both partners: Karyotype (chromosome analysis)
or 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
testicles is causing a problem with the sperm.
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
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
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Other Works Consulted
Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby.
May 10, 2013
Sarah Marshall, MD - Family Medicine & Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology
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