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Diagnostic Tests for Female Infertility 08/08/19 20.

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Diagnostic Tests for Female Infertility


When should I begin basic evaluation for infertility?

An evaluation of a woman for infertility is appropriate for women who have not become pregnant after ha
unprotected intercourse. Being evaluated earlier is appropriate after six months for women who are older
one of the following in their medical history or physical examination:
History of irregular menstrual cycles (over 35 days apart or no periods at all)
Known or suspected problems with the uterus (womb), tubes, or other problems in the abdominal ca
adhesions)
Known or suspected male infertility problems

Any evaluation for infertility should be done in a focused and cost-effective way to 5nd all relevant factors
male as well as female partners. The least invasive methods that can detect the most common causes of
5rst. The speed and extent of evaluation should take into account the couple's preferences, the woman's a
infertility, and unique features of the medical history and physical examination.

Click here to 5nd an ASRM doctor in your area. (/resources/5nd-a-health-profes

The following tests may be recommended as part of your initial infertilit


infertili
How is Ovulation Detection and Assessment done?

Urinary Luteinizing Hormone (LH)

Over-the-counter ovulation predictor kits detect the presence of LH in urine and can detect a rise in this ho
two days before ovulation. In contrast to blood progesterone levels, urinary LH tests can predict ovulation
LH testing helps de5ne the times of greatest fertility: the day of the LH surge and the following two days.
be expensive and should only be used by women with menstrual cycles that are consistently 25-35 days in

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Diagnostic Tests for Female Infertility 08/08/19 20.37

What is Ovarian Reserve Testing?

When attempting to test for a woman's ovarian reserve, the clinician is trying to predict whether she can p
good quality and how well her ovaries are responding to the hormonal signals from her brain. The most co
ovarian reserve is a blood test for follicle stimulating hormone (FSH) drawn on cycle day 3. In addition to t
physician may recommend other blood tests, such as estradiol, antimullerian hormone (AMH), and/or inh
transvaginal ultrasound to do an antral follicle count (the number of follicles or egg sacs seen during the e
cycle).
Ovarian reserve testing is more important for women who have a higher risk of reduced ovarian reserve, s

Here's more information on Ovarian Reserve Testing:


Ovarian Reserve (/news-and-publications/patient-fact-sheet
booklets/documents/fact-sheets-and-info-booklets/ovarian-r

Other Blood Tests:

Thyroid-stimulating hormone (TSH) and prolactin levels are useful to identify thyroid disorders and hyperp
cause problems with fertility, menstrual irregularities, and repeated miscarriages. In women who are thou
hirsutism (including hair on the face and/or down the middle of the chest or abdomen), blood tests for de
sulfate (DHEAS), 17-α hydroxyprogesterone, and total testosterone should be considered. A blood proges
second half of the menstrual cycle can help document whether ovulation has occurred.

The following tests are for evaluating the patency of your fallopian tubes and u

What is Hysterosalpingogram (HSG)?

Hysterosalpingogram is an X-ray procedure to see if the fallopian tubes are open and if the shape of the u
catheter is inserted into the opening of the cervix through the vagina. A liquid containing iodine (contrast)
catheter. The contrast 5lls the uterus and enters the tubes, outlining the length of the tubes, and spills out

Here's more information on Hysterosalpingogram (HSG


Hysterosalpingogram (/news-and-publications/patient-fact-sh
booklets/documents/fact-sheets-and-info-booklets/ovarian-r

What is Sonohysterography?

Sonohysterography is a procedure that uses transvaginal ultrasound after 5lling the uterus with saline (a s
detection of intrauterine problems such as endometrial polyps and 5broids compared with using transvag
If an abnormality is seen, a hysteroscopy is typically done. This test is often done in place of HSG.

What is Transvaginal Ultrasonography?

A Transvaginal Ultrasonography is an ultrasound probe placed in the vagina allows the clinician to check t
abnormalities such as 5broids and ovarian cysts.
What is Hysteroscopy?

Hysteroscopy is a surgical procedure in which a lighted telescope-like instrument (hysteroscope) is passe


view the inside of the uterus. Hysteroscopy can help diagnose and treat abnormalities inside the uterine c

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Diagnostic Tests for Female Infertility 08/08/19 20.37

5broids, and adhesions (scar tissue).

Why is a Laparoscopy performed?

Laparoscopy is a surgical procedure in which a lighted telescope-like instrument (laparoscope) is inserted


abdomen into the pelvic cavity. Laparoscopy is useful to evaluate the pelvic cavity for endometriosis, pelv
abnormalities. Laparoscopy is not a 5rst line option in the evaluation of a female patient. Because of its h
surgical risk, it may be recommended depending on the results of other testing and a woman’s history, suc
previous surgeries.

For best results, the infertility evaluation should be individualized based on each woman's speci5c circum

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ut-the-psychological-component-of-infertility/)
and-stem-cell-research/)
fertilization/)

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is a patient education website of ASRM (/link/9896b0090f9b4bbe8607cb41219f7d36.aspx).

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