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Tests and diagnosis

By Mayo Clinic staff

If you've been unable to conceive within a reasonable period of time, seek help from your doctor for further evaluation and treatment of infertility.

Fertility tests may include:

  • Ovulation testing. A blood test for progesterone, a hormone produced after ovulation, can document that you are ovulating. You can also check for this at home. An over-the-counter ovulation prediction kit — a test which you can perform at home — detects the surge in luteinizing hormone (LH) that occurs prior to ovulation.
  • Hysterosalpingography. This test evaluates the size and contour of your uterine cavity and checks whether your fallopian tubes are open. Fluid is injected into your uterus, and an X-ray is taken to determine if the uterine cavity is normal and whether the fluid passes out of the uterus and into your fallopian tubes. If abnormalities are found, you'll likely need further evaluation. In a few women, the test itself can improve fertility, possibly by flushing out and opening the fallopian tubes.
  • Laparoscopy. Typically done on an outpatient basis and under general anesthesia, laparoscopy allows your doctor to view your ovaries, fallopian tubes and uterus to check for endometriosis, scarring, blockages or irregularities. First, your doctor makes a small incision (8 to 10 millimeters) beneath your navel, and inserts a needle into your abdominal cavity. A small amount of gas (usually carbon dioxide) is inserted into the abdomen to create space for entry of the laparoscope — an illuminated, fiber-optic telescope. If you give consent before the procedure, your doctor can remove endometrial adhesions, treat scarring or remedy other problems with cutting instruments, lasers or ablation during the same procedure.
  • Ovarian reserve testing. Women at risk of a depleted egg supply — including women over age 35, those with autoimmune disease and smokers — may have this series of blood and imaging tests, which are performed on specific days of the menstrual cycle. They include blood tests of follicle-stimulating hormone (FSH) concentration on day three of your cycle; clomiphene citrate challenge test (CCCT), in which you receive five doses of the ovary-stimulating drug clomiphene citrate preceded and followed by a blood test to assess your estrogen level; ultrasound imaging of the ovaries to determine ovarian volume or follicle count; and blood tests to detect other markers of ovarian reserve.
  • Hormone testing. Testing for specific hormones, such as FSH and prolactin, can determine whether an undiagnosed medical condition might be interfering with your fertility.
Treatments and drugs Preparing for your appointment
References
  1. Kumar A, et al. Infertility. In: DeCherney AH, et al. Current Diagnosis & Treatment Obstetrics & Gynecology. 10th ed. New York, N.Y.: McGraw-Hill Medical; 2007. http://www.accessmedicine.com/content.aspx?aid=2392676. Accessed Nov. 24, 2009.
  2. Halvorson LM. Evaluation of the infertile couple. In: Schorge JO, et al. Williams Gynecology. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aid=3157679. Accessed Nov. 24, 2009.
  3. Doody KJ. Treatment of the infertile couple. In: Schorge JO, et al. Williams Gynecology. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aid=3158038. Accessed Dec. 1, 2009.
  4. Wright KP, et al. Infertility. In: Gibbs RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:705.
  5. American College of Obstetricians and Gynecologists. Management of infertility caused by ovulatory dysfunction. Obstetrics & Gynecology. 2002;99:347.
  6. Kuohung W, et al. Etiology of female infertility. http://www.uptodate.com/home/index.html. Accessed Nov. 18, 2009.
  7. Kuohung W, et al. Evaluation of female infertility. http://www.uptodate.com/home/index.html. Accessed Nov. 18, 2009.
  8. Kuohung W, et al. Overview of treatment of female infertility. http://www.uptodate.com/home/index.html. Accessed Nov. 18, 2009.
  9. Jose-Miller AB, et al. Infertility. American Family Physician. 2007;75:849.
  10. Devroey P, et al. Approaches to improve the diagnosis and management of infertility. Human Reproduction Update. 2009;15:391.
  11. Coddington CC (expert opinion). Mayo Clinic, Rochester, Minn. December 14, 2009.
DS01053 Sept. 9, 2011

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