Should You Be Evaluated for Infertility?

Infertility Testing for Women

The female workup can often be complicated and invasive, and many of the tests require that a woman be at a certain phase of her menstrual cycle. As a result, a woman's infertility evaluation can take three to four cycles to complete. Here are some of the tests it may include:

  • A full physical, including a pelvic exam, screening for STDs (such as chlamydia), blood tests, and urine tests.
  • An ovulation evaluation, which involves one to two months of charting with an ovulation-detection kit (the test uses daily urine samples to predict ovulation).
  • A series of blood tests at varying points in the menstrual cycle to evaluate hormones.
  • Pelvic ultrasounds to monitor follicle growth and the release of healthy eggs.
  • Pelvic ultrasounds, to monitor follicle growth and the release of healthy eggs
  • A hysterosalpingogram (an X-ray of the uterus and fallopian tubes after they've been injected with dye) to show the shape of the uterus and determine whether the tubes are open.
  • An endometrial biopsy (an evaluation of the uterine lining) to investigate hormonal imbalances that can cause irregular cycles, repeated miscarriages, or irregular uterine bleeding.

In some cases, a doctor will perform a laparoscopy to either confirm or rule out the presence of endometriosis, a disorder in which the endometrial tissue is found outside of the uterine cavity. During this procedure, which is done in an outpatient clinic under general anesthesia, a long, thin tube called a laparoscope is inserted into the abdominal cavity. The laparoscope is used to look at the internal pelvic area and outside the uterus, the fallopian tubes, and the ovaries for the presence of endometriosis.

The postcoital test (PCT) is also sometimes done to test the quality of a woman's cervical mucus and to see how well a man's sperm interacts with it. At the time of ovulation, a couple is instructed to have intercourse a specified number of hours before coming into the office. The doctor will then collect a swab of the woman's mucus, assess its quality and viscosity, and examine it for the presence of active sperm. The test allows a doctor to see how well a man's sperm can penetrate and survive in the woman's mucus.

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