Diagnosis of Infertility
There are a number of diagnostic tools available to help determine the cause of infertility. A diagnosis of infertility is usually given when a couple, after a year of trying to conceive, does not become pregnant. Based on your physical examination and medical history, your doctor may order tests to find structural or endocrine disorders. Even after testing, no cause can be found in 10 percent of people who have infertility.
Tests and Diagnosis of Infertility in Women
- Medical history – your doctor asks questions regarding your health history, menstrual cycle and sexual habits, history of sexually transmitted diseases, lifestyle and work environment, your pregnancy history and other health problems.
- Physical examination – It will include a pelvic exam, Pap smear, and examination of your breasts and thyroid gland.
- Ovulation testing – Ovulation testing is also used to assess your ability to produce eggs and to determine if your uterus is receptive to pregnancy during the second half of your menstrual cycle.
- Hysterosalpingography – HSG is an x-ray of the uterus and fallopian tubes that is usually performed in the first half of the menstrual cycle.
- Laparoscopy – It is performed under general anesthesia, in which the doctor inserts a small camera and fiber optic light through a small incision in your navel. Laparoscopy allows your doctor to view your ovaries, fallopian tubes and uterus to check for endometriosis, scarring, blockages or irregularities.
- Ovarian reserve testing – They include the following tests:
- Follicle-stimulating hormone (FSH) concentration on day three of your cycle
- Clomiphene citrate challenge test (CCCT), in which you receive five doses of the ovary-stimulating drug clomiphene citrate
- A blood test to assess your estrogen level
- Blood tests to detect other markers of ovarian reserve.
- A transvaginal ultrasound
- Hormone testing – Testing for specific hormones, such as FSH and prolactin, can determine whether an undiagnosed medical condition might be interfering with your fertility.
Tests and Diagnosis of Infertility in Men
- Medical history – Your doctor will ask questions about your disabilities, illnesses, medications and sexual habits.
- Physical examination – It includes examination of your genitals. It is useful for detecting large varicoceles, undescended testes, and absence of vas deferens, cysts, or other physical abnormalities.
- Semen analysis – Your semen is then sent to a laboratory to measure the number of sperm present and look for any abnormalities in the shape (morphology) and movement (motility) of the sperm.
- Scrotal ultrasound – It uses high-frequency sound waves to produce images inside your body.
- Transrectal ultrasound – It allows your doctor to check your prostate, and check for blockages of the tubes that carry semen.
- Hormone testing – Hormonal tests evaluate levels of testosterone and FSH (follicle-stimulating hormone) to determine the overall balance of the hormonal system and specific state of sperm production.
- Post-ejaculation urinalysis – It involves collecting a urine sample after orgasm and is checked for the presence of sperm.
- Testicular biopsy – It involves removing samples from the testicle with a needle. It may be used if your semen analysis shows no sperm at all.
- Vasography — To check the structure of the duct system and identify any obstructions
- Anti-sperm antibody tests – These tests are used to check for immune cells (antibodies) that attack sperm.