Infertility Testing usually consists of several stepwise tests to detect and then treat causes of infertility. It usually takes less than 6 weeks to find out the causes of infertility.
About 80% of infertility is caused by one or more of three problems.
Infertility and fertility testing must answer which of these may be responsible for the couple's inability to get pregnant, and most of these tests can be completed within 5 weeks:
Step 1: HIS Fertility
A male fertility test is the sperm analysis or sperm count and this test should be the very first step in fertility testing. This is a test done usually in a male infertilty clinic or a urologist. It should be done even before the womnan has any specific testing done.
The ejaculate is obtained through masturbation, placed in a sterile collection cup, and brought to the laboratory. The best results are obtained when the husband abstains for three days, and the sample arrives at the lab within an hour of ejaculation. The sample is then evaluated for volume, sperm count, motility (how many are swimming) and morphology (how many are a normal shape). Here is more information on how to obtain the semen.
Although normal values vary between laboratories, a normal count is typically >20 million/mL and normal motility and morphology are >50%. This test is done to rule out male causes for infertility, and to see if the couple might benefit from treatment such as artificial insemination.
Step 2: Ovulation Detection
The first question that must be answered is whether she is ovulating normally. Are there typical signs of ovulation?. Are the eggs of good ennough quality and has the couple made love regularly during the 5-6 fertile days before and the day of ovulation.
There are several ways to find out if and when you ovulate:
Step 3: Egg Quality and Hormones
Cycle Day 3:
7-10 Days after Ovulation
Step 4: Fallopian Tube Patency
Testing the fallopian tubes is essential when checking fertility. This can be by with an HSG or a laparoscopy.
Hysterosalpingogram (HSG) The HSG is an X-ray test in which dye is injected through the cervix and up into the uterus and fallopian tubes, while the doctor watches on a video screen. The HSG is usually done in the first half of the menstrual cycle, between the end of the menstrual period and before ovulation. The HSG is useful in determining if the fallopian tubes are open and if the cavity of the uterus is a normal shaped. There is a slight increase of fertility after this test.
Laparoscopy A laparoscopy is a surgical procedure in which a telescope is inserted into the abdomen, usually in the area around the belly button, and the pelvic organs are examined. This is usually done under general anesthesia, but in some instances is done under local anesthesia only. A laparoscopy is 'diagnostic' if used only to look at the organs, and it's 'therapeutic' when additional surgery is done as treatment.
Sonohysterogram A sonohysterogram is similar to an HSG except it is done in the doctor's office with ultrasound rather than an X-ray machine. Saline is injected through the cervix into the uterus, and the uterus and fallopian tubes are examined with ultrasound on a monitor.
Step 5: Other Tests