Infertility Tests

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Basic Tests

Through discussions with the couple about their medical history and a few basic tests, the doctor can often find an underlying reason for infertility. In these cases, treatments can address the problem. The initial tests determine semen quality, check for the production and release of eggs (ovulation), and assess the woman's reproductive organs (using an HSG).

Semen Analysis

The semen analysis, used to detect male fertility problems, should be performed immediately unless the man has recently proven fertility. He provides a semen sample by masturbation or through intercourse with the use of a special condom. A laboratory examines the sample for the volume of the ejaculate and the number (count), movement (motility), and the size and shape (morphology) of the sperm, as well as their ability to survive for several days.

If the semen analysis shows abnormalities, the man should consult with a urologist who is versed in infertility. Repeat the test if the semen analysis results are borderline.

Testing and monitoring ovulation

If the woman has regular menstrual cycles, the couple can do the first two of these tests at home to make sure they are having sex at the right time, just prior to ovulation.

Basal body temperature (BBT) charting

In most women, body temperature before ovulation is low (97.2 to 97.4°F) and rises above 98°F just after ovulation. A slight temperature rise (0.5°F) at the middle of the menstrual cycle indicates that ovulation could have occurred.

Beginning with the first day of menstruation, the woman takes her temperature immediately upon awakening each morning, using a basal thermometer. Basal thermometers give precise temperature measurements. She records the temperature on a BBT chart.Other events such as intercourse, bleeding, sleepless nights, or an illness should also be noted on the chart.

Ovulation test kits (the LH surge test)

The woman tests her urine for the presence of lutenizing hormone (LH) with an over-the-counter ovulation test kit. A woman's body produces a surge of LH before ovulation. A positive test result indicates that she will probably ovulate in about 12 to 36 hours.

Progesterone level (blood test)

Before ovulation, a developing follicle in the woman's ovary makes estrogen. When the follicle releases the egg at ovulation, the follicle remnant--the corpus luteum-- makes less estrogen and a greater amount of the hormone progesterone. Progesterone prepares the uterine lining for the arrival of the embryo and increases the basal body temperature. A blood test that shows higher progesterone levels is evidence of successful ovulation.

Hysterosalpingogram (HSG) Assessing the uterus and tubes

The HSG determines whether the uterine cavity is normal in shape and if the fallopian tubes are open. A specialist injects dye into the uterus and takes a series of x-ray pictures as the dye flows through the fallopian tubes and outlines the female reproductive tract.

The HSG can detect uterine fibroids, polyps, or an obstruction in one or both of the fallopian tubes. These conditions could prevent pregnancy and may require surgery.

This test is performed after a menstrual period but before anticipated ovulation.

In addition to the basic tests (semen analysis, ovulation testing, and HSG), physicians often perform several other tests for diseases, genetic conditions, and hormone levels at the beginning of a fertility investigation. Further tests include a post-coital test, endometrial biopsy, and immunology tests. Laparoscopy and hysteroscopy are surgical procedures that can be used for diagnosis or treatment.

See a fertility specialist now
We're a national network of over 100 fertility specialists.