How is Infertility Tested?

If you have been trying to have a baby without success, you may want to seek medical help. If you are over 35, or if you have reason to believe that there may be a fertility problem, you should not wait for one year before seeing a doctor.

A medical evaluation may determine the reasons for a couple’s infertility.

Usually this process begins with physical exams and medical and sexual histories of both partners.

If there is no obvious problem, like improperly timed intercourse or absence of ovulation, tests may be needed.

Fertility Ultrasound

An ultrasound scan is a widely used, safe and effective tool for evaluating fertility. A fertility ultrasound examination assesses fertility issues in both men and women. 

For women, ultrasound tests examine the condition of the patients

• uterus (womb),
• ovaries and
• fallopian tubes (the tubes that connect the uterus and the ovaries) in women

For men, ultrasound tests examine the condition of the patients

• condition of the prostate and
• seminal vesicles in men.
• Testicular volume and tumours
• Varicoceles (dilated veins)

The ultrasound procedure can be performed one of three ways depending on your situation:

• Transvaginal ultrasound scans: During the procedure, a small probe is placed into the vagina. The test helps your doctor to examine the health of your fallopian tubes, ovaries and uterus. Your doctor uses the results to evaluate the thickness of the uterine lining, presence of cysts, tumours and other abnormal growths which could be causing infertility.
• Transabdominal ultrasound scans: During the examination, a conducting gel is applied over your skin, and a transducer (a small handheld device) is moved over the lower belly. Transabdominal ultrasound examination is commonly performed to examine the health of your fallopian tubes, ovaries and uterus, follicle development, and to detect uterine fibroids, fallopian tube blockage and ovarian cysts.
• Transrectal ultrasound: This approach is commonly used in men to assess their pelvic organs including the prostate and seminal vesicles.

Infertility Tests for Women

Female infertility can be confirmed with the following tests:

• Blood tests measure your hormone levels and determine if you are ovulating.
• Biopsies may be obtained to evaluate the inner lining of your uterus.
• Ovarian reserve testing may determine the number and quality of eggs ready for ovulation.
• Imaging studies such as a pelvic ultrasound or hystero-sonography may be performed to obtain a detailed view of your fallopian tubes and uterus.
• Hysterosalpingography involves obtaining an x-ray image after injecting contrast material into your cervix, which travels up to your fallopian tubes. This can help identify any blockages in your fallopian tubes.
• Laparoscopic evaluation involves inserting a thin tube fitted with a camera through an incision in your abdomen to detect abnormalities in your reproductive organs, such as the ovaries, uterus and fallopian tubes.
• Checks of ovulation can also be done in the doctor’s office, using blood tests for hormone levels or ultrasound tests of the ovaries. If the woman is not ovulating, more tests will need to be done.

Infertility Tests For Men

An infertility test for a man usually begins with tests of his semen to look at the number, shape, and movement of his sperm. More advanced testing looks for sperm antibodies and sperm DNA damage.

Other tests, such as hormone and genetic tests, are done.

A diagnosis is often made by your doctor based on the following: 

• Medical history
• Complete physical examination
• Semen analysis: This is a laboratory test to assess sperm count and quality. The test sample is obtained by ejaculating into a sterile bottle.
• Transrectal ultrasound of the prostate: It is an investigation to evaluate the prostate gland and detect any obstruction of the ducts that transport the sperm.
• Scrotal ultrasound: This is an imaging test to diagnose abnormalities of the scrotum or testicles.
• Testicular biopsy: A small piece of tissue is removed from the testicle using a sterile needle and sent for evaluation under a microscope to help determine the cause of infertility.
• Anti-sperm antibody tests to trace the antibodies that attack sperm.
• Sperm DNA fragmentation test looking for damaged DNA in sperm which may cause poor embryo growth and increased risk of a miscarriage.