infertility diagnostic testing

Infertility Diagnostic Testing

Infertility may have many causes. The causes of infertility can be classified as female factor, male factor, combined or unexplained. Regardless of the cause of your fertility issues, we can help you maximize the chances of successfully conceiving and having a child.

Treating infertility starts with diagnosing the cause of your fertility problems. When evaluating female factors for infertility, we begin with a complete medical history and physical exam. That will help us determine the right course of action for you.

Infertility Diagnostic Testing

Basic Diagnostic Testing for Female Factor Infertility

Depending on the patient, tests we might run to test for female factor infertility can include:
  • Blood and Urine Tests to check hormone levels
  • Pap Smear to check the health of the cervix
  • Basal Body Temperature Test to determine if your ovaries are releasing eggs. Basal body temperature (BBT) is your morning body temperature before you get out of bed. When you ovulate, your ovaries release the hormone progesterone, which causes a slight rise in temperature. It remains elevated until right before menstruation, when it returns to normal. If your temperature doesn’t follow this pattern, it might indicate a problem. The BBT uses a special, ultra-sensitive thermometer to take your temperature and chart it over the course of a few months. If the test does indicate a problem, your doctor will do a blood test to confirm findings.
  • Endometrial Biopsy to determine if eggs have been released and whether the endometrium (lining of the uterus) has undergone the hormonal changes necessary for an egg to implant and grow into pregnancy. In this simple procedure, your physician will take a small tissue sample from the endometrium and examine it under a microscope. An endometrial biopsy is often done if the results of a Basal Body Temperature Test are unclear.
  • Ultrasound imaging to look for fibroids and cysts in your uterus and ovaries. This test uses sound waves to view the uterus and ovaries on a computer screen. It causes little discomfort and is very effective.
  • Post-Coital Test to test if sperm can survive in your cervical mucous. The physician takes a sample of mucous from your vagina to test how it interacts with sperm. The test must be performed during your fertile days and within 12 hours after sex.
Further Diagnostic Testing for Female Factor Infertility
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If more simple tests are inconclusive or more complex tests are required, they might include the following:

Laparoscopy

Laparoscopy, which is performed if your doctor suspects scarring in your ovarian or fallopian tubes, or endometriosis (a painful inflammation of tissue in the uterus).

Your doctor makes two small incisions at the pubic bone and navel, and then inserts a laparoscope (a long tube with lenses and a fiber optic light) into one incision, and a long probe through the other. With the probe, your doctor can view the ovaries, fallopian tubes and uterus to check for scar tissue.

In some cases, the physician may cut the scar tissue away. While the procedure typically requires general anesthesia, the risks are generally slight.

Hysterosalpingogram (HSG)

Hysterosalpingogram (HSG) checks the condition of your fallopian tubes. Using a needle, your physician injects a harmless dye through your cervix into your uterus.

Your physician then takes an X-ray to determine whether the dye passes through the open ends of the fallopian tubes. If the dye emerges, the tubes are not blocked.

In some cases, the dye actually clears away blockages in the fallopian tubes, restoring fertility. This test may also reveal other fertility problems such as fibroids, structural abnormalities and endometrial polyps.

Medical Management of Female Factor Infertility

If infertility is related to ovulation disorders, fertility medications are the primary treatment. These medications work by causing the release of hormones that either trigger or regulate ovulation.

Some medications are taken orally, while some are injected. Even if you are using assisted reproductive techniques such as IVF, fertility medications are still an important part of treatment.

+ Learn More About These Medications
Medical Management of Female Factor Infertility
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Clomid or Serophene

These often the first choice of medication because they have been effectively used for more than 40 years.

These medications cause the hypothalamus and pituitary glands located deep in the brain to release a set of hormones that will stimulate the ovaries to produce eggs. These medications are often used with assisted reproductive techniques or artificial insemination.

Injectable Hormones

Your doctor may recommend one of these to stimulate ovulation:

  • Human Chorionic Gonadotropin (hCG)
  • Follicle Stimulating Hormone (FSH)
  • Human Menopausal Gonadotropin (hMG)
  • Gonadotropin Releasing Hormone Agonist (GnRH agonist)

Additional Fertility Medications

Other fertility medications your physician may prescribe include:

  • Aspirin—in certain cases, studies have shown aspirin can reduce the risk of miscarriage
  • Heparin—a medication used to lower the risk of miscarriage in women who have repeated spontaneous miscarriages for specific causes
  • Antagon—an injected medication used to inhibit premature ovulation in women undergoing fertility procedures
  • Parlodel and Dostines, used to reduce the size of pituitary tumors, which can decrease ovulation, and to lower prolactin hormone

What Happens After Diagnosis

If we are able to identify a cause of fertility issues, whether female factor, male factor, or combined, we will recommend a course of treatment.

In some cases, this may be a fertility treatment such as IUI, IVF, or Donor Assisted Reproduction. In other cases, it may be a medical treatment for the underlying cause of the infertility.

What Happens After Diagnosis