When it’s time to take the next step in figuring out why you haven’t been able to get pregnant or carry a pregnancy to term, there are a lot of tests and tools to help your doctor investigate. I won’t sugarcoat it for you– some of the tests may be uncomfortable. But if you’re like me – the potential reward at the end of a maze of testing is well worth anything you may have to endure. And it might even prepare you for all the testing you’ll need to endure once you get pregnant!
OB/GYN’s highly recommend women have some tests and a consultation BEFORE they even start getting pregnant. Those tests include:
- Basic gynecological exam
- Testing for STD’s, which could cause infertility
- Blood tests: Hormone testing, including LH, FSH, thyroid, androgen hormones, prolactin, estradiol and progesterone. (see glossary)
- Ultrasound: The doctor will look for things like polycystic ovaries, ovarian cysts and fibroids. They will check the shape of your uterus and the thickness of the uterine lining. They’ll also do an antral follicle count, which predicts the quantity (not quality) of eggs available your ovaries.
The next level of fertility tests will come after you have been trying without success for a year and you’re under 35, or if you are older than 35 and it has been six months. You may also be able to jump right into these next round of tests if you’ve been having miscarriages or you have previous medical issues, like irregular periods, PCOS or endometriosis.
- HSG, or hysterosalpingogram: This exam checks the fallopian tubes to see if they are open and not blocked and will evaluate the shape of the uterus. It’s an outpatient procedure that involves placing an iodine-based dye through the cervix and then taking x-rays to see if the fallopian tubes are open or blocked – and they will also be able to evaluate the shape of the uterus to see if that may cause any issues. (Editor’s note: Some people have reported getting pregnant after this procedure, because it helped to open the tubes when dye was injected.)
- Hysteroscopy: If an HSG exam shows potential abnormalities your doctor may want a closer look inside the uterus. This exam uses a special camera to enter the uterus through the cervix. Your doctor may take an endometrial biopsy during this exam.
- Sonohysterogram: this test uses ultrasound to look at the inside of your uterus, after a saline solution is inserted via catheter.
- Genetic karyotyping: You and your partner may also need to take a blood test to evaluate genetic abnormalities that may put you at risk for having a child with a genetic or chromosomal disorder. The testing can also diagnose a genetic disorder that causes infertility.
- Diagnostic laparoscopy: This test would only be done after all of the other tests are completed and if you have symptoms that suggest endometriosis or pelvic inflammatory disease. The test involves the doctor inserting a specialized camera called a laparoscope into the abdomen through tiny incisions. The doctor can also repair blocked fallopian tubes during this procedure.
- If you are having miscarriages, you might take a test to see if you thrombophilia, also known as hypercoagulability. This condition makes someone more likely to develop abnormal blood clots. They might also have you take a blood test to see if you have an autoimmune disorder called Antiphospholipid antibody syndrome (APS), which can be another reason for miscarriages.
Male Fertility Tests
The main fertility test for men is a semen analysis, which is typically done two times on different days.
Additional testing may include:
- Specialized semen analysis that provides a more in depth analysis including genetic testing of the sperm
- Blood tests to check hormone levels
- STD testing
- Ultrasound to assess seminal vesicles and scrotum
- Urinalysis
- Vasography: an x-ray that can check for any blockages
- Testicular biopsy
I know that this all sounds like a lot, but remember – it’s a step by step process. With the right physician guiding you – you will come away with the knowledge you need to combat infertility and hopefully get you closer to the BFP (Big Fat Positive)!
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