When a couple has been unsuccessful at achieving pregnancy after one year, both partners need to go through a comprehensive physical and medical assessment. Tests for female infertility and a semen analysis should start immediately. Because male factors account for approximately 50% of all infertility cases, it is important to examine both partners for possible infertility issues.
A thorough clinical assessment of the couple should be made before any tests for infertility are carried out.Tests may be both invasive and non-invasive. The couple should be asked about their age, previous pregnancies, if any, frequency of intercourse, pain during intercourse and whether they use any lubricants during sex. Details about any relevant medical diseases that they may suffer from (like diabetes) and whether they take any medicines, either as recreational drugs or for any diseases should be inquired about.
Before a woman can start to undergo infertility treatment, it is necessary for her receive different female infertility tests. While there are a variety of tests that can be administered, perhaps the most important female infertility test is ovarian reserve testing. There are a variety of tests that can be done to assess a woman’s ovarian reserve. While no test can be accurate, some tests are more reliable than others.
Cervical mucus tests
This involves a postcoital test (PCT) which determines if the sperm is able to penetrate and survive in the cervical mucus. It also involves a bacterial screening.
Ultrasound tests
This is used to assess the thickness of the lining of the uterus (endometrium), monitor follicle development, and check the condition of the uterus and ovaries. An ultrasound may be conducted two to three days later to confirm that an egg has been released.
Hormone tests
These tests are done to assess the various hormone levels that contribute to the reproductive process. These hormone tests include the following:
o Luteinizing Hormone
o Follicle Stimulating Hormone
o Estradiol
o Progesterone
o Prolactin
o Free T3
o Total Testosterone
o Free Testosterone
o DHEAS
o Androstenedione
Hysterosalpingogram (HSG)
This is simply an x-ray of your uterus and fallopian tubes. A blue dye is injected through the cervix into the uterus and fallopian tubes. The dye enables the radiologist to see if there is blockage or any other problem.
Hysteroscopy
This is a procedure that may be used if the HSG indicates that there may be problems. The hysteroscope is inserted through the cervix into the uterus, which allows your fertility specialist to see any abnormalities, growths, or scarring in the uterus. The hysteroscope allows your physician to take pictures which may be used for future reference.
Laparoscopy
This is a procedure which uses a narrow fiber optic telescope. The laparoscope is inserted through a woman’s abdomen to look at the uterus, fallopian tubes, and ovaries. Your physician will be checking for endometriosis, scar tissue, or other adhesions. It is important to confirm that you are not pregnant before this test is performed.
Endometrial biopsy
This is a procedure which involves scraping a small amount of tissue from the endometrium just prior to menstruation. This biopsy is performed to assess whether there is a hormonal imbalance or not. It is important to confirm that you are not pregnant before this test is performed.
The list of diagnostic tests mentioned in various sources as used in the diagnosis of Female infertility includes:
