How is Infertility Tested?

If you’ve seen your GP, been referred to a gynaecologist or infertility clinic with suspected fertility issues, both of you will have to undergo infertility tests to try and determine what the cause is. There are various different types of test available, some of which are more invasive than others and some in which you collect the samples yourself, ready to be sent off for testing. One or more of these tests may be required, depending on your individual circumstances. Here’s a guide to some of the main forms of infertility tests in existence.

Initial Physical Test

In the very first instance, you’re likely to experience a physical test or examination. This will involve a general check of your health to see if there are any physical problems that could be affecting you. It’s also an opportunity to look for signs of infections that may be influencing your fertility.

Hormone Tests

Hormones can play a part in the fertility of both men and women, so one or both may have their hormones tested. This can be done via a simple blood test and, in the case of women; it’s usually carried out on or around day 21 of their cycle. At this time, it offers a good indication of your levels of hormones, whether ovulation is occurring and if there are any problems. In men the test is useful too, as hormone problems can affect the production of semen.

Semen Analysis

In many cases, men will need to provide a sample of semen for testing. This will allow experts to see how much sperm per ml there are, how many move forward and ensure they’re not abnormally shaped. Sometimes further tests are needed, for example, to look at the distance the sperm travel.

Post-Coital Test

This test takes place around the time of ovulation, as this is when a woman will have fertile mucus. A few hours after you’ve had sex, a sample of cervical fluid is obtained and analysed to look for motile sperm. Further tests may subsequently be required, for example if sperm aren’t able to penetrate into the mucus or if they die off in the mucus.

Exploration of the Testes

If no obvious reason for a man’s infertility can be found, then it may be necessary to surgically explore the testes. This can help highlight any blockages and where they are or infections that may be affecting fertility. Sometimes a small biopsy may be required as well.

Endometrial Biopsy

Sometimes infertility lies in the lining of the womb – the endometrium – not thickening in the way it should to prepare for a developing embryo. A biopsy, where a small sample of the uterine lining is removed, can help determine if this is the problem.

X-rays and Ultrasounds

Specialist x-rays and ultrasounds can be used to examine the fallopian tubes and in men to see what’s going on with the sperm. Ultrasound scans and x-rays can provide a clear picture of the uterus and ovaries, and any cysts, abnormalities or fibroids, plus it can see whether eggs are developing and being released as they should be. With another type of ultrasound test, a contrast solution is injected through the cervix and the scan follows it as it flows along the tubes, highlighting any problems en route.

Laparoscopy

To find out what’s going on in a woman’s abdomen, and in particular to check the uterus, ovaries and fallopian tubes, a laparoscopy may be carried out. It’s done under general anaesthetic as day surgery.

The exact test, or tests, you’ll have will depend very much on your own individual circumstances, but your doctor or specialist will advise you every step of the way.