Common tests for infertility
The road to fertility treatment is paved with tests for both partners - here we outline those most frequently used
Posted: 5 December 2007
When a couple has difficulty in conceiving there may be a problem with the woman's fertility, the man's fertility, or with both, so testing both partners is usually recommended. As it's relatively straight-forward to check the quality of a man's semen, it's usually advisable to get a semen analysis done before embarking on any of the more invasive physical investigations for the female. Here's a summary of the most common fertility tests for women and you can find the tests for men summarised here.
Common fertility tests for women
- Blood, urine and cervical fluid (mucous) - Your doctor may start with relatively straight-forward tests of your blood, urine and cervical fluid to check whether or not you're ovulating and to check hormone levels, such as that of FSH and luteinising hormone. If a problem with ovulation is detected then this can often be successfully treated with drugs such as Clomiphene (Clomid, Serophene). Be aware that if you go on for further investigations, not all clinics will be happy to accept the results of these tests without repeating tests of their own.
- Post-coital test for fluid compatibility -
If you appear to be ovulating normally and your partner's semen has been given the all-clear, a further test may be to test the compatibility of the two: It may be that the cervical fluid doesn't reach the right consistency to let the sperm swim through to reach the cervix and go on to fertilise an egg, or it could be that the cervical fluid contains antibodies against the sperm to the same effect. Just prior to ovulation, a sample is taken from the woman's vagina within two to eight hours of a couple having sex. The sample is analysed to check whether the sperm can move freely through the cervical fluid to reach the cervix. If a semen analysis hasn't been done to establish the motility of the sperm in the seminal fluid, a cross-check will have to be done to see whether the antibodies limiting the sperm's movement are being produced by the man or the woman.
- Ultrasound - Ultrasound imaging uses soundwaves to create a picture of what's going on inside the body, and can enable doctors to get a good look at your reproductive organs, for example to check whether you are producing follicles to release eggs, or to look for Polycystic Ovarian Syndrome (PCOS). Unlike an x-ray it uses no radiation, so it's very safe, it is also entirely painless. If you embark upon fertility treatment then you're quite likely to have several ultrasounds for various purposes. Depending on what the doctors wish to see, the ultrasound will either be abdominal, on your stomach, or transvaginal, with a scope inserted into the vagina, which may be slightly uncomfortable.
- Endometrial biopsy - The physical health of your womb is crucial to establishing a pregnancy: With each cycle the womb lining should thicken in preparation for nurturing a fertilised egg. Infections and other uterine abnomalities can interfere with this process and create a hostile environment for a developing embryo. An endometrial biopsy is a relatively straightforward procedure where a sample of the lining of your womb is removed via a plastic catheter and suction for testing. The test is very quick and shouldn't be painful, but it may be uncomfortable and the catheter can provoke uterine cramping.
- Hysterosalpingogram (HSG) - This checks whether there is any blockage in your Fallopian tubes and can also be used to check the uterus for fibroids and/or scar tissue. A radiographic dye is injected into the uterus through the vagina using a thin catheter or similar and then x-rays are taken to show how the dye moves around the reproductive area. The procedure itself should only take 5-10 minutes, is non-invasive and so doesn't require a general anaesthetic. However, as with the endometrial biopsy, you may experience some uteral cramps afterwards.
- Laparoscopy - A laparoscopy involves key-hole surgery, usually under a general anaesthetic, and allows doctors to get a very clear picture of your reproductive organs to check for abnormalities. A tiny optical tube is inserted through a very small incision in the navel area to look for abnormalities which, if found, the surgeon may also be able to repair in the course of the operation. Before surgery, carbon dioxide gas is delivered to the abdominal cavity (via a special needle inserted just below the navel) to separate the individual organs in the abdomen and so give surgeons a clearer picture of what's happening. the procedure usually only involves a day-visit to hospital, but as it involves a general anaesthetic and perhaps some abdominal discomfort you're likely to need several days to recover.
Common fertility tests for men
Common fertility tests for men are summarised here.
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