Infertility Tests
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Basic Tests
Through discussions with the couple about their medical history and a few
basic tests, the doctor can often find an underlying reason for
infertility. In these cases, treatments can address the problem. The
initial tests determine semen quality, check for the production and
release of eggs (ovulation), and assess the woman's reproductive organs
(using an HSG).
Semen Analysis
The semen analysis, used to detect male fertility problems, should be
performed immediately unless the man has recently proven fertility. He
provides a semen sample by masturbation or through intercourse with the
use of a special condom. A laboratory examines the sample for the volume
of the ejaculate and the number (count), movement (motility), and the
size and shape (morphology) of the sperm, as well as their ability to
survive for several days.
If the semen analysis shows abnormalities, the man should consult with a
urologist who is versed in infertility. Repeat the test if the semen
analysis results are borderline.
Testing and monitoring ovulation
If the woman has regular menstrual cycles, the couple can do the first
two of these tests at home to make sure they are having sex at the right
time, just prior to ovulation.
Basal body temperature (BBT) charting
In most women, body temperature before ovulation is low (97.2 to 97.4°F)
and rises above 98°F just after ovulation. A slight temperature rise
(0.5°F) at the middle of the menstrual cycle indicates that ovulation
could have occurred.
Beginning with the first day of menstruation, the woman takes her
temperature immediately upon awakening each morning, using a basal
thermometer. Basal thermometers give precise temperature measurements.
She records the temperature on a BBT chart.Other events such as
intercourse, bleeding, sleepless nights, or an illness should also be
noted on the chart.
Ovulation test kits (the LH surge test)
The woman tests her urine for the presence of lutenizing hormone (LH)
with an over-the-counter ovulation test kit. A woman's body produces a
surge of LH before ovulation. A positive test result indicates that she
will probably ovulate in about 12 to 36 hours.
Progesterone level (blood test)
Before ovulation, a developing follicle in the woman's ovary makes
estrogen. When the follicle releases the egg at ovulation, the follicle
remnant--the corpus luteum-- makes less estrogen and a greater amount of
the hormone progesterone. Progesterone prepares the uterine lining for
the arrival of the embryo and increases the basal body temperature. A
blood test that shows higher progesterone levels is evidence of
successful ovulation.
Hysterosalpingogram (HSG) Assessing the uterus and tubes
The HSG determines whether the uterine cavity is normal in shape and if
the fallopian tubes are open. A specialist injects dye into the uterus
and takes a series of x-ray pictures as the dye flows through the
fallopian tubes and outlines the female reproductive tract.
The HSG can detect uterine fibroids, polyps, or an obstruction in one or
both of the fallopian tubes. These conditions could prevent pregnancy and
may require surgery.
This test is performed after a menstrual period but before anticipated
ovulation.
In addition to the basic tests (semen analysis, ovulation testing, and
HSG), physicians often perform several other tests for diseases, genetic
conditions, and hormone levels at the beginning of a fertility
investigation. Further tests include a post-coital test, endometrial
biopsy, and immunology tests. Laparoscopy and hysteroscopy are surgical
procedures that can be used for diagnosis or treatment.
See a fertility specialist now
We're a national network of over 100 fertility specialists.