Infertility Tests

Semen analysis

A semen analysis measures semen volume and quality, as well as sperm quantity, concentration, morphology (shape) and motility (how well they swim). The analysis also looks for white blood cells in the semen, which might mean an infection.

Hormonal tests

Several hormones are tested repeatedly during your menstrual cycle to determine whether a hormone imbalance is the cause of your infertility. Follicle stimulating hormone and luteinizing hormone (LH) are measured at the beginning of a cycle. Blood levels of LH are measured again around mid-cycle when you ovulate, and for a third time a week later. Sometime during your cycle, the doctor measures blood levels of some or all of the following hormones: prolactin, thyroid stimulating hormone, free T3, free thyroxine (T4), total testosterone, free testosterone, DHEAS and androstenedione.

Other tests

Blood from both partners may be tested for AIDS, hepatitis and bacterial infections. Along with blood work, your doctor might order one or more of these tests:

• Hysterosalpinogram (HSG). Radio opaque dye is injected through the cervix into the uterus and fallopian tubes. A special X-ray machine then scans the pelvic region before the fluid is allowed to flow out. The X-ray images can help the doctor diagnose fibroid tumors, an unusually shaped uterus, scar tissue or blockages in the fallopian tubes. If you have a blocked tube, the procedure can be extremely painful. Take ibuprofen about half an hour before.
• Hysteroscopy. If the result of the HSG suggests the presence of a uterine problem, your doctor may do a hysteroscopy to look inside the uterus. The procedure uses a hysteroscope - a thin telescope passed through the cervix into the uterus.
• Post-coital test. This painless office procedure is typically done the day you ovulate and several hours after sex. A small amount of cervical mucus is removed and examined under a microscope. The PCT determines how compatible a man's sperm is with his partner's cervical mucus.
• Endometrial biopsy. A sample of the endometrium (tissue lining the inside of the uterus) is removed and studied under a microscope. Problems with the endometrium are called luteal phase defect. The test checks to see if the endometrium can support implantation and growth of a fertilized egg. The test must be done about three days before your period starts.
• Laparoscopy. After you get local or general anesthesia, your doctor makes a small incision into your abdomen and inserts a narrow fiber-optic telescope into the pelvic area. This allows the doctor to inspect the outside of the uterus, the fallopian tubes and ovaries for endometriosis, pelvic adhesions or other problems.
• Testosterone testing. The doctor may want to measure the man's testosterone levels to see if they are high enough. The doctor measures the level by taking blood from your arm. A woman may also get the test if she is having irregular periods or none at all. Testosterone levels can rise in women because of tumors that develop in the ovaries or PCOS.

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This article was reviewed and updated June 2007.