|
The detective work needed to identify the cause of your infertility can be time-consuming, expensive and even painful. One way to save time is to have your family doctor or internist send copies of your medical history to your infertility specialist (preferably a reproductive endocrinologist or a gynecologist who specializes in infertility treatment). Here are some standard tests.
Semen analysis
A semen analysis measures semen volume and quality, as well as sperm quantity, concentration, morphology (shape) and motility (how well they swim). The analysis also looks for white blood cells in the semen, which might indicate an infection.
Hormonal tests
If possible, schedule your first consultation on day three of your menstrual cycle, since baseline blood tests for hormones known as follicle stimulating hormone (FSH) and luteinizing hormone (LH) should be done on that day. (Day one is the first day you bleed.) Blood levels of LH are measured again around mid-cycle when you are ovulating, and for a third time about a week later. Sometime during your cycle, the doctor measures blood levels of some or all of the following hormones: prolactin, thyroid stimulating hormone (TSH), free T3, free thyroxine (T4), total testosterone, free testosterone, DHEAS and androstenedione.
Other tests
Blood from both partners is tested for such diseases as AIDS, hepatitis and bacterial infections known to affect fertility. In addition to blood work, your doctor might order one or more of the following diagnostic procedures:
- Hysterosalpinogram (HSG). Radio opaque dye is injected through the cervix into the uterus and fallopian tubes. The pelvic region is then scanned by a special X-ray machine before the fluid is allowed to flow back out. The X-ray images can help the doctor diagnose fibroid tumors, an unusually shaped uterus, scar tissue or blockages in the fallopian tubes. Ask your doctor or radiologist to inject the dye very slowly to minimize discomfort. If you have a blocked tube, the procedure can be extremely painful.
- Transvaginal ultrasound. This test may be performed to view the woman's pelvic organs. A device is inserted into the uterus to enable the doctor to look at the ovaries and uterus.
- Hysteroscopy. If the result of the HSG suggests the presence of a uterine abnormality, your physician may do a hysteroscopy to see the inside of the uterus. The procedure uses a hysteroscope -- basically a thin telescope that is passed through the cervix into the uterus.
- Post-coital test (PCT). This painless office procedure should be done the day you ovulate and several hours after intercourse. The procedure involves removing a small amount of cervical mucus and examining it under the microscope. The PCT assesses compatibility of a man's sperm with his partner's cervical mucus.
- Endometrial biopsy. This test can detect whether and when ovulation is occurring. The main purpose of this procedure is to discover if you have a luteal phase defect, a progesterone deficiency that can lead to early miscarriage. The doctor collects a small sample of tissue from the endometrium (uterine lining) between 11 and 13 days after the LH surge that spurs ovulation.
- Laparoscopy. After the patient is given regional or general anesthesia, a narrow fiber-optic telescope is placed into the pelvic cavity through a tiny abdominal incision. This allows the doctor to inspect the exterior of the uterus, the fallopian tubes and ovaries for any evidence of endometriosis, pelvic adhesions or other abnormalities.
Don't give up hope if your diagnostic work-up doesn't show anything. This happens in nearly one in five cases. The tests can rule out many problems, such as blocked fallopian tubes, and can only help you and your doctor develop a logical treatment strategy.
|
Related Articles
|
|
External Sources
 |
Fertility Plus
|
|
Brigham and Women's Hospital
|
|
The American College of Obstetricians and Gynecologists
|
|
This article was reviewed and updated
June 2007.
Return to the previous page
|
