Tests for Diagnosis of Female Infertility

For couples struggling to conceive, it raises the question of whether either partner has a problem with fertility. There are several fertility tests available to both partners to help screen and diagnose the problem. Here are a few fertility tests that your doctor may use to evaluate your condition.

  1. Ovulation testing: This is a common test for infertility that is readily available, is non-invasive, and uses a kit that you can buy over the counter. It checks for luteinizing hormone, and you can perform this test at home to detect the LH surge. Your doctor can also order a blood test for progesterone, a hormone produced by the corpus luteum at the time of ovulation.
  2. Laparoscopy: This examination allows the examiner to view the uterus, fallopian tubes and ovaries and determine whether any abnormalities are present. Any endometriosis, scarring, or blockages would be apparent upon laparoscopy. The procedure begins with a small incision below the navel, and a needle is passed into the abdominal cavity. Then carbon dioxide gas is used to inflate the cavity to allow easy passage of a laparoscope. The laparoscope is simply a thin, flexible, illuminated, high-resolution fiber optic camera. Patients have the option to give consent to their doctor to remove any adhesions, scarring, or perform surgical procedures on any findings. Laparoscopy is performed under general anesthesia, however it is becoming more available as an outpatient procedure.
  3. Hysterosalpingography: this is a radiographic examination that examines the size and contour of the uterine cavity, as well as the patency of the fallopian tubes. Any blockage or closure of the fallopian tubes would be easily identified by this test. The procedure involves injecting fluid into the uterus and into the fallopian tubes, and an X-ray is taken to check for any abnormalities. Not only is this examination diagnostic, but it is therapeutic, since the fluid may be able to flush out and open the fallopian tubes to allow passage of an oocyte.
  4. Ovarian reserve testing: This examination is recommended for women over age 35, or suffering from a chronic autoimmune disease, and smokers, since they are often at risk for having a decreased supply of oocytes. This series of blood tests and imaging examinations and the component examinations are performed on different stages of the menstrual cycle. These include the following examination:
    • Testing for follicle-stimulating hormone on day 3
    • Clomiphene citrate challenge test for estrogen levels
    • Ultrasonography of the ovaries to assess the volume of the ovaries, as well as follicle count
    • Other blood tests to determine other markers of ovarian reserve

In cases where female infertility has been determined, then the appropriate course of action may be pursued. Advances in assistive reproductive therapy have success stories worldwide, and here in the Philippines, in-vitro fertilization can be performed to give hope to struggling couples.