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There are certain tests that are required to evaluate infertility in women. It usually starts with knowing the medical history of the patient, physical examination, and some preliminary tests.
Female Fertility Evaluation
Medical history - The past medical history may provide some clues to help evaluate the cause of infertility. The doctor usually asks about childhood development;sexual development at the time of puberty , sexual relationship , infections past surgical history any illness , medications taken previously or currently, exposure to any kind of chemicals,radiation, previous evaluated infertility, consumption of alcohol, smoking , steroids etc.
Menstrual history - Patient suffering from irregular periods (Oligomenorrhea), no signs of menstrual periods(Amenorrhea), these could be some of the causes that can affect infertility, and ovulation. These problems can interfere with infertility, however is does not mean that you cannot become pregnant.
Physical examination - It generally includes a general examination , which is conducted to check and see if there are any signs of hormone deficiency or any other signs and other conditions that relate to infertility. A pelvic examination is also conducted to check and see if there are any abnormalities of the reproductive tract and also signs of low hormone level. This examination can be done at a clinic by the patient's general physician or by a infertility specialist.
Blood tests - A blood test is done to detect the hormone level, that plays an important part in woman fertility, the pituitary gland, the hypothalamus and ovaries,are the key in producing hormones. To assess how well the ovaries are functioning ,these hormones include (FSH) follicle-stimulating hormone, TSH to test the thyroid function, and prolactin to check if there is a pituitary tumor which is benign.
Tests to evaluate ovulation - A woman;s menstrual history or hormone levels, such as pre-ovulation LH surge or luteal phase progesterone, can detect abnormalities of ovulation. Ovulation is the release of an egg from an ovary.
Basal body temperature -A woman;s temperature usually rises by 0.5°F to 1.0°F after ovulation. Basal body temperature is difficult to detect and are not generally recommended in the evaluation of infertility. Basal body temperature is usually measured before getting out of bed.
Hormone levels - Hormone levels can be detected by an over-the -counter urine test. However there is no guarantee that this kit will help in detecting the hormone surge. Usually the Levels of luteinizing hormone (LH) rise abruptly approximately 38 hours before ovulation. The clinician may recommend a blood test. You can detect more accurately to indicate ovulation, by the blood levels of the hormone progesterone. The levels of progesterone are usually measured after the first menstrual period , after the first day 18-24 days.
Tests to evaluate the uterus and fallopian tubes - Scarring , or any obstruction to the fallopian tubes can occur as a result of (PID) pelvic inflammatory disease, endometriosis, (scar tissue), from any previous abdominal infection or surgery. These are some of the causes that can contribute to infertility. Uterine abnormalities also can be the cause of infertility which include congenital structural abnormalities, such as uterine septum( a band of tissue that makes the uterine cavity small).
Hysterosalpingogram: Is a test that is taken with a help of an x-ray of the fallopian tubes and uterus, where a dye is injected , to show the shape of the uterus and if the tubes are open
Laparoscopy: A test done to examine the female organs , the tubes, for disease, using a small light -transmitting tube called a laparoscope. The test is done when the woman is under general anesthesia, the tube is inserted in the abdomen through an incision.
Endometrial biopsy: An examination of a small shred of uterine lining to see if the monthly changes in the lining are normal.
Genetic tests - Genetic tests are conducted , if there any reason to doubt that there are any chromosomal or genetic abnormalities, which contribute to infertility. These tests are conducted by a small blood test, which is sent for evaluation.
Genetic counseling is recommended , to educate the couple about the possibility , of carrying this genetic disorder to the child , if there are abnormalities they can be treated to prevent the transmission from parent-child. Reproductive techniques are considered to overcome genetic or chromosomal abnormalities.