Necessary tests for female infertility
If pregnancy has not been achieved within a reasonable time of unprotected intercourse, a specialist should be consulted to evaluate and treat the infertility.
The fertility tests for women may include:
- Ovulation test
- Ultrasound hysterosalpingography
- Genetic testing
- Ovarian reserve test
This may be performed by monitoring the body temperature, although this method tends not to be used that much these days due to its limited accuracy, by a urine test that detects increased levels of luteinizing hormone (LH), which develops before ovulation, or by ultrasound. The levels of other hormones, such as prolactin, are also checked.
The patency and anatomy of the fallopian tubes, as well as the uterine cavity, are evaluated. If any disorders are detected, further evaluation is required.
It is performed by a radiologist, who injects radiopaque solution in the interior of the uterus through a simple catheter inserted in the cervix. As the solution flows, it depicts the shape of the uterus and the pathways of the fallopian tubes under X-ray. So it mainly helps establish whether the fallopian tubes are open and, quite accurately, whether their functionality is limited by the presence of adhesions.
It is best if this exam is performed towards the end of the period and up to just before ovulation. It lasts approximately 10 minutes. It is accompanied by mild pain. For this reason, women take a mild painkiller and antispasmodic medicine just before the exam.
This is a newer test and is similar to a hysterosalpingography; however, it is performed by a specially trained gynecologist. They follow the same procedure as the radiologist, by injecting special fluid or foam in the uterus, while at the same time observing via transvaginal ultrasound how it flows from the uterus to the fallopian tubes. It is a relativity painless exam performed at a gynecologist’s office and lasts a few minutes. This exam is gaining new ground, as it is painless and does not involve radiation exposure.
- There is no radiation burden for the woman, as is the case with conventional hysterosalpingography.
- There is no risk of allergy, due to the nature of the special hypoallergenic foam.
- There is minimal to zero discomfort during the exam.
- It is quick.
A transvaginal ultrasound of the uterus and ovaries is performed at the same time and valuable information is extracted about the condition of these organs.
The pelvic ultrasound examines possible lesions in the uterus (fibroids), the ovaries (cysts) and occasionally the fallopian tubes (hydrosalpinx). Depending on the findings, the doctor may request further investigation.
It is a minimally invasive surgical procedure to examine the fallopian tubes, ovaries and uterus. Laparoscopy may detect endometriosis, adhesions, occlusions or fallopian tube disorders. Ideally it must be performed on all couples when the cause of infertility (unexplained infertility) cannot be detected after rigorous testing.
It is endoscopy of the uterus that examines the uterine cavity for possible problems (such as polyps, adhesions and fibroids), which can be addressed during the procedure. Hysteroscopy can be performed on its own or at the same time as a laparoscopy.
Genetic testing verifies whether there is a genetic defect that causes infertility.
Ovarian reserve test
It checks the number of the more developed tertiary ovarian follicles left in the ovaries. This is performed via ultrasound and provides the ovarian age of a woman. The anti-Müllerian hormone (AMH) blood test provides a similar result about the ovarian reserve of a woman and can be performed on any day of the cycle.
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