Fertility Testing & Diagnosis
Fertility testing & diagnosis overview
- Fertility tests can verify causes of infertility in women and in men, aiding in the diagnosis and treatment.
- In general, men and women should consider fertility testing if they have not been able to achieve pregnancy after a year of having unprotected intercourse on a regular basis.
- Fertility tests may begin with a physical exam and include semen analysis, blood work, special imaging and other specific procedures.
What is fertility testing & diagnosis?
When couples experience infertility, there is an equal chance that the cause is male infertility or female infertility. Appropriate testing ensures accurate diagnosis of the underlying cause, male or female, and the proper treatment options.
The fertility doctor will perform a physical exam for the male and female partner and will talk about their health and sexual history to try to narrow down the possible cause(s) for infertility. This is important as sometimes the cause of infertility is a lack of understanding on how to get pregnant, and a couple may only need guidance from the physician for timing intercourse.
The initial search to identify a reason for infertility should focus on the most common causes and involve the least invasive approach possible. Further testing may be necessary to diagnose either male infertility or female infertility.
Male infertility tests
The male partner’s sperm will be tested after collection through masturbation or surgical extraction. Male infertility is most often determined by factors related to sperm quality, quantity of production and motility (amount of movement). Tests are usually conducted in our office and include:
- Semen analysis, a variety of tests and retrieval methods may be appropriate
- Hormone level analysis, usually of testosterone (T), Prolactin (PRL) and follicle-stimulating hormone (FSH), can evaluate the ability to produce sperm and the man’s level of sex drive.
Female infertility tests
Various tests for infertility in women may be administered, depending on the individual woman’s history and physical exam. The following tests may be appropriate:
- Ovarian reserve tests to evaluate a woman’s remaining supply of eggs, which reduces as she ages
- Uterus testing, such as vaginal ultrasound, hysterosalpingogram (HSG), sonohysterogram and hysteroscopy, can determine if fibroids, polyps, scarring or tumors have compromised the uterus’ ability to achieve and maintain a healthy pregnancy
- Fallopian tube tests can determine that the tubes are clear and able to transport a sperm to the egg and the resulting embryo to the uterus. Both x-ray tests, such as the hysterosalpingogram and blood tests, can be used to check tubal function.
- Hormone tests can evaluate various issues and include Anti-Mullerian hormone (AMH), estradiol (a form of estrogen) and follicle-stimulating hormone (FSH) testing.
Who should consider fertility testing & diagnosis?
- A woman should consider fertility testing if she has not achieved pregnancy after a year of having unprotected intercourse on a regular basis
- Women over age 35 should consider infertility testing after six months of trying to conceive
- Testing should also be considered at any time by women who
- Men should consider testing if they
- have a problem releasing sperm through ejaculation
- are suspected of infertility, as determined by the physician
What are the risks of fertility testing & diagnosis?
Semen analysis, blood work and many imaging tests involve extremely little risk. Women may face risks associated with surgical procedures used in some tests, such as laparoscopy for abdominal cavity assessment and hysteroscopy for uterus examination.
Your doctor will discuss these risks with you before administering any tests.