| Basic Information |
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| Description |
- Some infertility tests are for women only, others are for
men only, and still others cannot be done without the cooperation of both partners.
- An initial workup for a woman can take as little as six to
eight weeks, or as much as three months or longer because
some of the tests may have to be repeated for verification at different specific times in her menstrual cycle.
- The initial workup of a man usually can be done faster
both because men have no monthly cycles-and because
there are fewer tests for men.
- Diagnostic surgical procedures may be suggested for both
men and women to look directly at reproductive structures
and to obtain small tissue samples for laboratory analysis.
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| Female's Tests |
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These tests are more varied and extensive than for males and generally begin with an analysis of if and when the woman is ovulating.
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| Basal body temperature: |
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One of the most popular techniques for pinpointing ovulation relies on the typically slight rise in resting body temperature midway in the menstrual cycle, signaling that ovulation has recently occurred. A woman's body temperature
fluctuates throughout her menstrual cycle, and she is
instructed to record these fluctuations on a chart after taking her temperature each morning before getting out of
bed. If the chart-called a basal body temperature, or BBT,chart-indicates that the woman has been ovulating, it can
often be used to predict when ovulation will happen during
subsequent menstrual cycles. The couple can then use the
information to attempt to time conception. Several urine
test kits for sale over the counter can be used to supplement the temperature chart.
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| Hormone tests: |
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Laboratory blood and urine studies to measure hormones that play a role in fertility. Tests may be done at the start of
the menstrual cycle, in the middle or at the end.
Progesterone increases in plasma after ovulation. It can be measured to confirm that ovulation has occurred.
Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) help stimulate ovulation. If their levels are low or
high, or if they do not fluctuate properly, infertility can
occur. Other hormones measured include prolactin, testosterone and thyroid stimulating hormone (TSH). In addition,
blood studies can detect the presence of antibodies to
sperm.
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| Cervical mucus: |
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Other methods widely used to predict ovulation rely on
examinations of the cervical mucus, which undergoes a
series of hormone-induced changes at various times in the
menstrual cycle. Some versions of these tests require a
health professional's expertise. There are, however, versions of them that
some women-with a physician's guidance-can learn to do themselves.
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| Endometrialbiopsy: |
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A long, hollow tube is passed into the patient's uterus late in
her menstrual cycle, and a little of the lining is scraped off
and examined with a microscope. The examination helps
the physician tell whether the development of the egg and
of the lining are in proper phase with each other. In most
cases, the scraping is done in a physician's office and
because it is only very briefly painful no anesthetic is used.
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| Ultrasound: |
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This technology relies on sound waves to produce images
of internal structures. It is used, often in combination with
one or more of the tests already discussed, to find the presence or absence of follicles that contain and release the eggs. Ultrasound is also used to detect abnormalities in the
ovaries or uterus.
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| Hysterosalpingogram: |
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This is an x-ray study of the uterus and fallopian tubes. It is
done just after a woman's menstrual period so there is no
danger of her being pregnant and thereby exposing the fertilized egg or embryo to radiation. A dye containing iodine-technically called a contrast medium-is injected through
the cervix. It spreads into the uterus and the fallopian tubes,
allowing them to be visualized on x-ray. Among other
things, this study often enables the physician to determine
if the fallopian tubes are open. It is usually done without an
anesthetic in the x-ray department of a hospital or clinic.
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| Hysteroscopy: |
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The patient's uterus is filled with a liquid or gas, instilled
through the cervix. A small lighted telescope called a hysteroscope is then inserted into the uterus through the
cervix, enabling the surgeon or physician to look directly
inside. Many hysteroscopes have a separate channel
through which instruments can be passed, often making it
possible to immediately correct any abnormalities. Patients
undergoing hysteroscopy are usually given an anesthetic,
which may be local or general.
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| Laparoscopy: |
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A laparoscope, like a hysteroscope, is a small lighted telescope. It is slipped into the abdominal cavity through a
small incision in or near the navel. For a dearer view of the
woman's reproductive tract, the cavity is filled with gas during the procedure, and a colored solution-usually blue-is
injected into the uterus and fallopian tubes. A general anesthetic is required. Advanced operative techniques may
allow the repair of defects in the reproductive tract to be
made at the same time as the examination.
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| Male's Test |
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| Semen analysis: |
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It is almost always the first test done on men and is usually
repeated several times. After abstaining from intercourse for
about 48 hours, the man collects a semen sample in a container. The sample is microscopically examined to determine the number, activity and shape of individual spermatozoa (sperm cells) and the characteristics of the fluid part of
the semen. A healthy, potent ejaculate typically contains 1.5
to 5 cubic centimeters (5 cc = I teaspoon) of semen and
each cc will contain an average of 70 million sperm that
look to be of normal size, shape and behavior. If the specimen markedly differs on any of these factors, further tests
may be done to determine whether infection, hormonal
imbalance, or another problem could be the culprit.
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| Testicular biopsy: |
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This is a minor operation-performed with a local or general
anesthetic-in which a small amount of tissue from the
testes is removed for laboratory studies. Since even men
with sperm counts well below 70 million per cubic centimeter sometimes father children, this test is ordinarily
done only when the count is zero. If damage to one or both
of the vas deferens is known or suspected, an x-ray examination may also be ordered. As an iodine containing solution has to be injected into the tubes to make them visible
on x-rays, the patient is first given a local or general anesthetic. If the examination discloses damage, surgical repairs
are often attempted at the same time the diagnosis is made.
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| Other special tests: |
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May be ordered if none of the tests already mentioned
seems to explain the man's infertility. They may help in
some cases, but results are uncertain in others. In the
bovine (cow) mucus test, mucus from the cervix, or neck
of the uterus (where it opens into the vagina) is placed in a
special glass column. Samples of the man's semen are
applied to the column, and measurements are made of how
well the sperm are able to enter and swim through the
mucus, giving some indication of their ability to swim
through human cervical mucus. In the hamster oocyte penetration test, some of the man's semen is mixed with hamster egg cells that have had their outer shells (membranes)
removed. If the sperm are functioning normally, they will
penetrate the hamster eggs, an indication that they are also
capable of fertilizing human eggs. However, failure of the
sperm to penetrate the hamster eggs does not always mean
that they are incapable of fertilizing human eggs.
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| Couple's Tests |
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| Postcital test: |
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This test requires participation of both partners, as it has to
be done after intercourse, which has to take place at the
most fertile time in the woman's cycle. During the test at a
doctor's office, 2 to 12 hours after intercourse, several samples of
cervical mucus are taken. Laboratory analysis determines whether sperm and
mucus have been able to properly interact.
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| Other tests: |
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There are also a variety of tests that are used when the doctor suspects that infertility may be due to the man's forming
antibodies against his own sperm or the woman's forming
antibodies against them. The exact nature of these immunological problems is not yet well understood, but their detection is sometimes helpful in explaining why a couple is having reproductive difficulty. Some of these tests require the
participation of both partners; others, either one or the other.
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| Note |
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A final word about all infertility tests: It is always best to ask
in advance why they are being suggested, what they may
show, how definitive they are, what the possible remedies
are for any problem they may disclose, and what side
effects or complications are possible from a given test.
Many of these tests have potential risks as well as potential benefits.
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| Notify Your Healthcare Provider If |
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You are interested in more information about infertility tests.
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