When a couple is having difficulty conceiving a child, the issue may lie with one or both partners. Infertility is defined as the inability to conceive after one year of unprotected sex.

According to the Centers for Disease Control and Prevention (CDC), approximately 6.1 million women in the United States between ages 15-44 have difficulty getting pregnant or staying pregnant. When facing fertility issues, it’s essential to undergo testing to determine what may be causing infertility. In this article, we’ll explore the different exams you can expect when undergoing fertility testing.

Medical History and Physical Exam

During the initial consultation with a fertility specialist, they will first assess the couple’s medical history and perform a physical exam. The doctor may ask questions about the couple’s health, sexual habits, and any previous pregnancies.

The doctor may also inquire about any medications the couple is taking that could interfere with fertility, such as birth control pills or anti-depressants.

The physical exam will include a pelvic exam on the female partner to assess the health of the reproductive organs.

The doctor will also check for signs of male infertility, such as varicoceles (enlarged veins in the scrotum) and testicular lumps that could affect sperm production.

Ovulation Tests

A woman’s ability to conceive depends on her ability to ovulate regularly and produce healthy eggs. The first exam a fertility specialist will perform on a woman having trouble conceiving is an ovulation test.

This test analyzes the hormones responsible for ovulation, such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH).

Several methods are used to monitor ovulation, including:.

Basal Body Temperature Monitoring: The woman takes her temperature upon waking each day and records it on a chart. The rise in temperature indicates ovulation has occurred.
Ultrasound: The doctor uses a vaginal ultrasound to observe the ovaries and determine whether follicles are maturing or eggs have been released
Urinary Ovulation Predictor Kits: These kits test the levels of LH in a woman’s urine to predict ovulation will occur within 24-48 hours.

Sperm Analysis

The sperm count, motility (movement), and shape can play a significant role in male fertility. A semen analysis is usually the first test a man will undergo when seeking fertility treatment.

The man provides a semen sample, which is then analyzed in a laboratory. The results of this test can help diagnose male-factor infertility causes.

Some of the factors assessed in a sperm analysis include:.

Concentration: The number of sperm per milliliter of semen.
Count: The total number of sperm per sample.
Motility: The percentage of sperm that are moving.
Morphology: The shape of the sperm and the percentage that are considered normal.

Hysterosalpingogram (HSG)

A hysterosalpingogram is an x-ray exam designed to identify any abnormalities in the uterus or fallopian tubes that may prevent conception.

During an HSG, a dye is injected into the cervix, and x-rays are taken to observe the dye flow through the uterus and fallopian tubes.

Some of the potential issues that HSG can identify include:.

Blocked fallopian tubes
Uterine fibroids or polyps that could interfere with implantation
Abnormalities in the shape of the uterus

Hormone Testing

Several hormones play a role in fertility and pregnancy, including estrogen, progesterone, and thyroid hormone. Hormone testing may include blood tests to measure these hormone levels.

If necessary, additional testing may be ordered to assess possible thyroid or pituitary gland issues that could interfere with fertility.

Laparoscopy

Laparoscopy may be ordered when other tests fail to identify the cause of infertility. During this minimally invasive procedure, the doctor inserts a tiny camera through a small incision in the abdomen.

The camera allows the doctor to examine the pelvic organs up close. In some cases, the doctor can remove scar tissue or unblock the fallopian tubes during this procedure.

Genetic Testing

Some couples experience fertility issues due to genetic abnormalities. Testing may be ordered to evaluate both partners for any genetic issues that could affect pregnancy or the baby’s health.

In some cases, assisted reproductive technologies, such as IVF with pre-implantation genetic diagnosis (PGD), may be used to help couples conceive.

Conclusion

Infertility can be an overwhelming and emotionally challenging issue for couples to face. However, by undergoing appropriate diagnostic exams and exploring treatment options, couples can increase their chances of starting or expanding their family.

If you’re experiencing difficulty conceiving, consult a fertility specialist who can help diagnose and treat the underlying cause of infertility.