Fertility Tests

Fertility tests can be:

• Non-invasive
• Invasive

Non-invasive tests include:

1. Basal Body Temperature chart (BBT) (please see fertility awareness): This test is simple and easy to learn. It is cheap and has been used for ages as a guideline to detect ovulation.
   
2. Blood Tests on sexually transmitted diseases (STD) such as syphilis, Chlamydia, hepatitis B and HIV. These tests may indicate genital infections which may contribute to the fertility problem.
   
3. Blood tests to check the levels of female hormones, thyroid hormones, and milk hormone (Prolactin). These would be useful if the menstrual cycle is irregular or absent.
   
4. Semen Analysis. The test is easily done by masturbation or by using non-spermicidal condom during sexual intercourse. The semen analysis will check the number, shape, and motility of the sperm. However, if the test is not normal in the first instance, it should be repeated as the values fluctuate considerably day by day and are dependent on many factors. If the semen analysis suggests low sperm count, blood tests on male hormones may be indicated.
   
5. Ovulation kits: (please see fertility awareness) There are many test kits in the market. The accuracy and false results vary. Generally, they are accurate in predicting ovulation.
   
6. Postcoital test. This test requires that you have intercourse several hours in advance and then visit your doctor to have a sample of cervical mucus taken for microscopic examination. It's a way of testing both the viability of the sperm and their interaction with the cervical mucus. The accuracy of this test varies depending on whether it is done at the time of ovulation and the cervical mucus is of good quality.
   
7. Transvaginal (pelvic) ultrasound exam. An ultrasound is done to check the condition of the womb (uterus) and ovaries. Often the doctor can determine whether the follicles (eggs) in the ovaries are working normally. Thus, the ultrasound is often performed 15 days before a woman's expected menstrual period.
   
8. Hysterosalpingogram (HSG) or "tubogram." In this procedure, a series of X-rays is taken of the fallopian tubes after a liquid dye has been injected into the womb (uterus) through your cervix and vagina. The HSG can help diagnose fallopian tube blockages and defects of the uterus. If one of the tubes is blocked, the obstruction should be apparent on the X-ray since the liquid dye won't get past it. An HSG is usually scheduled between days six and 13 of your cycle. The procedure can be uncomfortable and a block tube could be due to spasm since the patient is conscious.

Invasive tests include:

1. Hysteroscopy. In this procedure, a thin telescope-like instrument is inserted through the cervix into the uterus to allow the doctor to see and photograph the area to look for problems. It is done under local or general anesthesia.
   
2. Laparoscopy. In this, a laparoscope is inserted into the abdomen through a small incision to look for endometriosis, scarring, and other conditions. It is done under general anesthesia.
   
3. Endometrial biopsy. This procedure is done by removing a sample of tissue from the lining of the womb (endometrium) with a catheter that is inserted into the uterus through the vagina and cervix to see if it is normal, so an embryo could implant in it. The procedure is somewhat uncomfortable; therefore, a painkiller is given beforehand.

Not all women undergo all these tests. Your doctor will guide you through those that are most appropriate for you. After the testing is done, about 85% of couples will have some idea why they are having problems getting pregnant.