What tests are done first? Tests to find the cause of infertility | Who | Test name | Description | | Both partners | Medical history | Your doctor will ask questions about your sex life, your birth control methods, any sexually transmitted disease (STDs), medicine use, and the use of caffeine, tobacco, alcohol, or illegal drugs. Your menstrual cycle and exercise patterns will be checked. If STDs are suspected, more tests may be done. | | Physical examination | A complete physical examination of both you and your partner is done to check your health. - A woman's physical examination usually includes a pelvic examination and Pap test. For more information, see the medical tests Pelvic Examination and Pap Test.
- A man's physical examination usually includes a testicular examination. For more information, see the medical test Testicular Examination. Not all fertility doctors will do a physical examination of the man. If there are problems with the semen, the doctor may refer the male partner to a urologist.
| | Blood or urine tests | - Luteinizing hormone (LH) and progesterone tests may be done during a woman's menstrual cycle to help see whether she is ovulating. LH may be checked in a man to see whether he has a pituitary gland problem. For more information, see the medical tests Luteinizing Hormone (LH) and Progesterone.
- Thyroid function tests may be done to check for thyroid hormone problems that may be preventing ovulation. For more information, see the medical tests Thyroid Hormone Tests and Thyroid-Stimulating Hormone (TSH).
- Prolactin is a hormone made by the pituitary gland. It may be checked if a woman has menstrual cycle or ovulation problems. For more information, see the medical test Prolactin.
- In some cases, follicle-stimulating hormone (FSH) may be used to check a woman's egg supply (ovarian reserve). Experts question the value of the FSH testing for infertility. For more information, see the medical test Follicle-Stimulating Hormone. FSH testing may also be used for men with a very low number of sperm to try to find out the source of the problem.
- A testosterone test may be used to see whether a problem with the testicles or pituitary gland is preventing a man from being able to father a child. A low amount of testosterone can lead to low sperm counts. For more information, see the medical test Testosterone.
- Tests for sexually transmitted diseases (STDs) may be done. These may include urine samples or samples from the cervix or urethra.
| | Man | 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 made. For more information, see the medical test Semen Analysis. | | Woman | 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. For more information, see the medical test Postcoital Test. | | 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 same time. For more information, see the medical test Fertility Awareness. | What if the first tests do not find a cause?
If the first tests do not find a cause for infertility, the woman may have one or more of the following tests. Tests for women to find the cause of infertility | Test | Description | | Pelvic ultrasound | 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. For more information, see the medical test Pelvic Ultrasound. | | Hysterosalpingogram | 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. For more information, see the medical test Hysterosalpingogram. | | Sonohysterogram | A sonohysterogram is an ultrasound test that uses saline and ultrasound to look at the female reproductive organs. | | Endometrial biopsy | 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. For more information, see the medical test Endometrial Biopsy. | | Laparoscopy | 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 general anesthesia. For more information, see the medical test Laparoscopy. | What other tests may be done? If a 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. Other tests to find the cause of infertility | Who | Test name | Description | | Both | Antibody blood tests | 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. For more information, see the medical test Antisperm Antibody Test. | | Karyotype (chromosome analysis) or genetic test | - Karyotyping is a blood test that looks for problems in the genetic material (chromosomes) in your cells. Some genetic problems make it hard to become pregnant or cause miscarriages. For more information, see the medical test Karyotype Test.
- Genetic tests may be done to help find the cause of infertility. For more information, see the medical test Genetic Test.
| | Man | Ultrasound | Ultrasound uses sound waves to make a picture of structures inside the body. It may be done to see whether a problem in the testicles is causing a problem with the sperm. For more information, see the medical test Testicular Ultrasound. | | 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 testicles. For more information, see the medical test Testicular Biopsy. | | Woman | 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 fallopian tube. For more information, see the medical test Hysteroscopy. |
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