|What Are Fertility Tests?
A fertility test is a procedure or test which assesses the ability of a woman to have a baby. There are also fertility tests for men, but we will limit the scope of this article to women. There are a range of female tests available; some are simple to perform like peeing on a stick in the comfort of your own bathroom while others are invasive and involve diagnostic surgery under general anesthesia. Most women start at level one, with simple tests and if there is a problem diagnosing the cause, more complex tests can then be ordered.
All about female infertility and all about male infertility.
For more specially about men, see male fertility tests.
What Are Home Fertility Tests?
These are over-the-counter tests you can buy in any pharmacy. They can be taken at home to gauge your fertility potential. Most women start with these tests; in fact their doctor may recommend it to help pinpoint their ovulation (indicating their most fertile days). Popular home tests include:
Ovulation Prediction Kit (OPK)
An OPK is used to detect luteinizing hormones (LH) levels, higher levels generally confirm you are ovulating. It may also be used to pinpoint the exact day you ovulate so that you can plan to have sex with your partner on that day. You normally have a 12 to 24 hour window to fertilize a released egg before it dies. It is also recommended to have sex regularly for a few days before ovulation because the quality of the sperm tends to be better if the man has had a little 'practice'. Another useful home test is one that measures follicle stimulating hormone (FSH) levels. This type of test also lets you know whether or not you are ovulating (one popular brand is First Response Fertility Test for Women). This information is particularly useful for women with polycystic ovary syndrome (PCOS) or irregular periods who may not know if they are ovulating.
If you want to go higher tech you can buy a fertility monitor which is a small device that stores data about your menstrual cycle and tells you when you are going to ovulate (cost about $100-$200). Examples include Clearblue Fertility Monitor, Persona Monitor and Cyclotest Temperature Fertility Monitor.
Basal Body Temperature
If you want to go low-tech, you can use the old fashioned method of recording your basal body temperature (BBT). This is the lowest temperature your body reaches within a 24 hour period. You pop a basal thermometer into your mouth first thing in the morning before getting out of bed and record your temperature. Several studies show that most women ovulate after their temperature has risen, so by tracking your temperature, you know when to have sex. Finally you may choose to monitor changes in your cervical mucus. Before ovulation it tends to be thick and cloudy but in the days approaching ovulation it becomes thinner, transparent and slippery.
When Should I See A Doctor For Testing?
It is recommended that women under the age of 30 wait a year before seeking fertility tests. Women over 30 should seek a diagnosis after 6 months. But you might want to consider fertility testing straight away if you:
• Have a history of painful periods or irregular periods.
• Have problems pinpointing when you ovulate.
• Have a history of sexually transmitted diseases (STDs).
• Experienced one or more miscarriages.
• Have an unhealthy body mass index (BMI) - either you are very overweight or underweight.
• Have had a prior treatment for cancer or require treatment and want to preserve your fertility.
• Have endometriosis or PCOS.
• Are aged over 40. See, what age does fertility go down in women?
• See also, how long does it take to get pregnant?
At The Doctors
You may choose to see a family doctor or gynecologist, or some women go directly to a fertility clinic. If at any time your doctor feels your case is more complex than he can handle, or he feels you need fertility treatment, he will send you to a specialist or clinic. Initially you will be given a full physical examination and you will be checked for symptoms of PCOS and symptoms of thyroid disease. You may also be given a Pap smear test. Ideally you will have been tracking your ovulation with an OPK or using the BBT method. This will tackle the first question that needs answering: are you ovulating or not?
Baseline Blood Tests
Next you may be given a blood test to check your hormone levels (also known as baseline blood tests). Blood is drawn on day 2 or 3 of your period and the results are normally back within a few days. From the results it may be revealed that you have an undiagnosed condition like PCOS which is affecting your fertility. Or if you have high levels of FSH it may mean you have started perimenopause. Or high levels of estradiol can indicate ovarian cysts. Many women receive a diagnosis at this stage and are treated with infertility drugs to boost ovulation.
Cervical Mucus Test
Also called a post coital test (PCT) or Huhner test, the cervical mucus test is done around the time of ovulation. It determines if your partner's sperm can penetrate and survive the mucus in your cervix. A sample of your mucus is taken 4 to 12 hours after sex and examined under a microscope for signs of sperm survival.
An ultrasound scan may be performed to check the size and condition of the womb and ovaries. If no cause can be determined at this point, or a previously undiagnosed condition is indicated, the diagnostic procedure is stepped up a level and more specific tests may be recommended.
Additional Diagnostic Tests
This uses an X-ray to check the size and shape of your fallopian tubes and womb. It will highlight if there are any blockages in the fallopian tubes or if there are any other abnormalities preventing pregnancy such as uterine fibroids, endometriosis or benign growths called polyps. These are some of those most common causes of infertility. A small tube is inserted into the cervix and a dye squirted through it. An X-ray will be used to follow the progress of the dye. If it stops in any of your tubes this indicates a blockage. It is performed under local anesthesia or mild sedation (with a Valium). If there are blockages, these may need minor surgery to repair. In a few women the test itself can improve fertility by flushing out and opening the fallopian tubes. You may find the procedure uncomfortable but not painful.
A sonohysterogram is similar to a HSG, except a saline solution rather than a dye is injected; and an ultrasound is used rather than an X-ray. It is very effective for evaluating the uterus but is less useful for checking the fallopian tubes. It is used more for following up on surgeries or to verify findings from a HSG. It is less uncomfortable than a HSG.
Laparoscopy is a surgery performed under general anesthesia. First the abdomen is inflated with gas through a small incision near the belly button. Then a small camera device with a light (laparoscope) is inserted through the navel. This surgery can be used for exploratory purposes, or it can be used for treating a condition. If endometrial scar tissue is found it can be removed during the surgery with cutting tools, lasers or ablation (you will need to give your consent beforehand). See also endometriosis treatment.
Sometimes it can be hard to see fibroids or small polyps using a HSG, so for a closer look at the womb, your doctor might recommend a hysteroscopy. It is usually performed with local anesthesia, cervical block or mild sedation. A tube is guided through the cervix and into the womb. Some gas is squirted through the tube to inflate the area so that the doctor can see things more easily. Images of your uterus are transmitted onto a screen for analysis.
Endometrial biopsy involves taking a small scraping from the endometrium (tissue lining the womb) just before menstruation. This will help determine if the lining is thick enough to support a pregnancy. An endometrial biopsy is also used for making an endometriosis diagnosis, particularly if there are endometrial implants that are still too small to see with the naked eye.
Less Common Tests
Your doctor may also recommend tests for:
• Infections (chicken pox, rubella, hepatitis or STDs).
• Genetic testing for genetic disorders like Tay-Sachs, cystic fibrosis or sickle cell.
How does a doctor test for infertility in women? More related info.
How does a doctor test for infertility in men? Male testing overview.
Is it possible to be a little bit pregnant? When you feel early symptoms
How can I increase my fertility naturally? Trying alternative options.