Testing and Diagnosis of Female Infertility

For a woman to be fertile, her ovaries must release healthy eggs. Her reproductive tract must allow an egg to pass into her fallopian tubes and allow the sperm to join the egg for fertilization. The fertilized egg must travel on to the uterus and implant in the lining. Tests for female infertility attempt to determine whether any of these processes are impaired. To determine if the female partner has problems concerning ovulation, egg transport, fertilization or implantation, various tests may be administered based on the physician’s examination and analysis:

Ovulation tests: Ovulation tests are used to determine your fertile days so you can maximize your efforts in trying to conceive.

Ovarian reserve testing: Women are born with their lifetime supply of eggs, and these gradually decrease in both quality and quantity with age.
Most widely used tests to see ovarian reserve are basal follicle stimulating hormone (FSH), anti-Mullerian hormone (AMH) and antral follicle count (AFC).

Other hormone testing: Other hormone tests check levels of ovulatory hormones, as well as thyroid and pituitary hormones that control reproductive processes.

Hysterosalpingogram (HSG): This test checks the condition of the women’s fallopian tubes. During hysterosalpingography, X-ray contrast is injected into your uterus and an X-ray is taken to detect abnormalities in the uterine cavity and tubal patency.

Diagnostic laparoscopy: This minimally invasive surgery involves making a small incision beneath your navel and inserting a thin viewing device to examine your fallopian tubes, ovaries and uterus. A laparoscopy may identify endometriosis, scarring, blockages or irregularities of the fallopian tubes, and problems with the ovaries and uterus.

Hysteroscopy: Often done in conjunction with a laparoscopy to examine visually the interior of the uterine cavity for scar tissue, adhesions, polyps, tumors, and other abnormalities.

Ultrasound: A pelvic ultrasound looks for uterine, ovarian or fallopian tube disease. It can reveal the thickness of the uterine lining (the endometrium) and its response to hormonal stimulation and as well as growth of the ovarian follicles can be monitored.

Endometrial biopsy: Used to determine if the endometrium, the lining of the uterus, has responded appropriately for implantation of the embryo.

Polycystic ovarian disease (Anovulation) profile –(PCOS): Is a very common reproductive disorder. Women with polycystic ovaries often need help conceiving. This profile includes all the tests to be done in women with anovulation.

Genetic testing. Genetic testing helps determine whether there's a genetic defect causing infertility.