Basic Infertility Tests

There are many tests that can be performed in an effort to determine the cause(s) of one’s inability to conceive.  Some of these can be performed by your Primary Care Physician and/or OB/GYN, while other, more advanced diagnostic tests should be performed by a Reproductive Endocrinologist.

There are several categories of infertility tests.

Blood Tests may determine if there is a male or female infertility factor—or both.

• FSH is a basic test which measures follicle-stimulating hormone and evaluates female egg supply.  It is done on the third day of the menstrual cycle.  For men, FSH is present and regulates the production and transportation of sperm.  Therefore, an FSH test would determine male sperm count.
• Luteinizing hormone (LH) test measures a woman’s egg supply or ovarian reserve.  The test occurs during a woman’s menstrual cycle to see if she is ovulating.  LH testing can also meaure a male’s sperm count, as LH is a testerone stimulator, which in turn affects sperm production.
• Progesterone is a female hormone produced during ovulation.  It is helpful to measure progesterone levels in the blood as you can determine whether or not ovulation is occurring.  Progesterone causes the lining of the uterus to thicken, preparing it to receive a fertilized egg.
• Testosterone is a hormone produced by both men and women.  In women, a testosterone test could be useful in determining the cause of irregular periods.  Decreased sex drive can be evaluated as well.
• Estradiol is a form of estrogen.  Two important pieces of information can be gleaned from an estradiol test:  the quality of the eggs themselves can be evaluated, and a woman’s ovarian function can be measured.
• Prolactin is a hormone excreted by the pituitary gland and measuring prolactin may give insight into why women aren’t menstruating.  Prolactin can be measured in men as well.

Occasionally, blood testing will not determine the cause of infertility.  It might be necessary to have Anatomical Diagnostic Tests performed to make sure that the uterus and fallopian tubes are functioning properly.

• A test can be conducted to see if your fallopian tubes and uterus are functioning properly (no tube blockage) and that they are structurally sound.  An HSG (Hysterosalpingogram) involves inserting a thin tube into the uterus via the cervix.  A small amount of dye is injected, enabling the X-ray image to be read.
• A water sonogram (or sonohysterogram) can show abnormalities of the uterus.  These abnormalities may include polyps.  This test employs the use of  ultrasound via saline,  not dye, to show the doctor the uterus and its wall.

Yet another route your physician may choose involves outpatient surgical diagnostic testing.

• A doctor might want to see inside and/or all around the outside of your uterus.  In order to see inside, you might undergo a hysteroscopy.  This test may help determine if your infertility is caused by any abnormalities in the shape or size of the uterus, uterine fibroids or scar tissue.  The doctor can also see more clearly the endometrial (uterine) lining.
• Your doctor may want to see outside and around the uterus, and examine the uterus, fallopian tubes and ovaries.  Like an HSG test, this test will show any blockage in the fallopian tubes.  Endometriosis can also be discovered and even treated at this time.