Diagnostic Tests for Infertility

Infertility affects women or men both physically and mentally. Couples must undergo diagnostic tests for infertility because diagnosing the cause of infertility is very important and challenging.

Before starting any treatment doctor first understand the causes of infertility. They perform the physical exam and medical history and recommend diagnostic tests such as blood tests, semen analysis, and ultrasound. Infertility evaluation can be expensive, and sometimes the procedure can be even uncomfortable.

Let’s see the infertility diagnosis for both Men and Women.

Diagnostic Test for Female Infertility

To diagnose the cause of infertility in women, the doctor may perform following diagnostic tests for infertility : –

Endocrine System Test

All the hormone-producing glands that regulate the body’s growth, metabolism, and sexual development are included in the endocrine system. And sometimes problems in the endocrine system may lead to infertility, that’s why a doctor may perform various diagnostic tests for infertility such as: –

Basal Body Temperature Charting (BBT)

BBT charts can predict the time of ovulation and if there is any problem with ovulation. The average body temperature increases slightly at a higher level of progesterone. So, to create a BBT chart, women record their temperature every morning before getting out of bed. And if there is a constant temperature means, there is no ovulation. Many other tests are available that help identifies the time of ovulation, such as Ovulation Predictor Kits (OPK), which are usually Urinary Luteinizing Hormone (LH) tests.

The interpretation of the BBT chart is essential in diagnosing female infertility. A significant increase in temperature after ovulation is an indication that ovulation has occurred. The temperature typically stays elevated for about two weeks until menstruation begins. If the temperature remains elevated beyond two weeks, it could be a sign of pregnancy.

The basal body temperature (BBT) is the temperature of a person at rest. In women, BBT may rise by 0.3 – 0.6°C (0.5 – 1.0°F) during ovulation. By keeping track of their BBT every day, women can potentially determine if and when they ovulate. Throughout a typical menstrual cycle, BBT fluctuates as follows:-

Irregular Menstrual Cycle

Women with irregular menstrual cycles can use BBT charting to help diagnose infertility. If a woman’s temperature chart shows no significant temperature increase after two weeks, it could be an indication that ovulation has not occurred. Women with irregular cycles should take their temperature every morning for at least three months to obtain accurate results.

Other Benefits of BBT Charting

BBT charting is not only useful for diagnosing infertility but also for predicting ovulation. Women who are trying to conceive can use the BBT chart to identify the best time to have intercourse. The chart can also be used to monitor the effectiveness of fertility treatments and to track changes in hormone levels.

Ovulation Predictor Kits

If you’re trying to conceive, understanding your menstrual cycle is essential. Ovulation predictor kits (OPKs) are a useful tool for predicting when you’ll ovulate, making it easier to time intercourse to increase your chances of getting pregnant. In this guide, we’ll cover everything you need to know about ovulation predictor kits, including what they are, how they work, and how to use them effectively.

What are Ovulation Predictor Kits?

Ovulation predictor kits are home testing devices that can help you predict when you’re most likely to ovulate. These kits measure the levels of luteinizing hormone (LH) in your urine, which surges just before ovulation. When LH levels rise, it indicates that ovulation is likely to occur within the next 12-36 hours.

How do Ovulation Predictor Kits Work?

Ovulation predictor kits work by detecting the LH surge that occurs just before ovulation. When you use an ovulation predictor kit, you’ll collect a urine sample and test it with the kit’s test strip or midstream device. The test will indicate whether or not your LH levels are elevated. If the test is positive, it means that ovulation is likely to occur within the next 12-36 hours.

Advantages of Using Ovulation Predictor Kits:-

There are several advantages to using ovulation predictor kits, including:

• Increased accuracy in predicting ovulation: OPKs can provide a more accurate prediction of ovulation than tracking your menstrual cycle alone.
• Better timing for intercourse: By predicting when ovulation is likely to occur, you can time intercourse for the days when you’re most fertile, increasing your chances of getting pregnant.
• Cost-effective: Ovulation predictor kits are relatively inexpensive and can be used multiple times.

Disadvantages of Using Ovulation Predictor Kits

There are a few disadvantages to using ovulation predictor kits, including:

• False positives: Ovulation predictor kits can occasionally produce false positives, indicating that ovulation is imminent when it is not.
• Stress and anxiety: Trying to conceive can be stressful, and using ovulation predictor kits can add to that stress if you become obsessed with tracking your ovulation.
• Can’t predict pregnancy: Even if you’re accurately predicting ovulation, there’s no guarantee that you’ll become pregnant.

Types of Ovulation Predictor Kits

There are two main types of ovulation predictor kits:-

• Test Strip kits:- Test strip kits are similar to pregnancy tests and involve dipping a test strip into a cup of urine to check for LH levels.
• Midstream Devices:-Midstream kits are used like a traditional pregnancy test and involve urinating directly onto the test stick.

When to Start Testing

The timing of ovulation varies from woman to woman and from cycle to cycle, but it usually occurs around day 14 of a 28-day menstrual cycle. However, it’s important to note that not all women have a 28-day cycle, and some women ovulate earlier or later than day 14.

To determine when to start testing, you’ll need to track your menstrual cycle and start testing a few days before you expect to ovulate. Most manufacturers recommend starting testing around day 10 of your cycle, but you should follow the instructions that come with your kit.

How to Use an Ovulation Predictor Kit

Using an ovulation predictor kit is easy, but it’s important to follow the instructions carefully to get accurate results. Here are the general steps for using an ovulation predictor kit:

• Step 1:-Determine when to start testing based on your menstrual cycle.
• Step 2:- Choose a testing method (test strip or midstream device).
• Step 3:- Collect a urine sample at the same time each day.
• Step 4:- Follow the kit’s instructions for testing the urine sample.
• Step 5:– Record your results and track them on a fertility chart or app.
• Step 6:- Have intercourse on the days leading up to and including ovulation.

Interpreting Results

Ovulation predictor kits are designed to be easy to read. If the test line is darker than the control line, it means that your LH levels are elevated and ovulation is likely to occur within the next 12-36 hours. If the test line is lighter or the same color as the control line, it means that your LH levels are not elevated, and ovulation is not likely to occur within the next 12-36 hours.

Are Ovulation Predictor Kits Accurate?

Ovulation predictor kits are generally accurate, but there are a few things that can affect their reliability. Some factors that can impact the accuracy of ovulation predictor kits include:

• Irregular cycles: Women with irregular cycles may have trouble predicting ovulation.
• PCOS: Women with polycystic ovary syndrome (PCOS) may have higher baseline levels of LH, which can make it harder to detect the surge.
• Medications: Certain Infertility medications, such as those used to treat infertility, can impact LH levels and make it harder to accurately predict ovulation.
• User error: Using the kit incorrectly, testing at the wrong time, or misreading the results can also impact accuracy.

To increase the accuracy of ovulation predictor kits, it’s important to follow the instructions carefully, test at the same time each day, and use multiple methods of tracking ovulation, such as tracking basal body temperature and cervical mucus changes.

2. Endometrial Biopsy

After ovulation, on days 7 to 12 fertility specialist takes a sample of the cells that line the uterus to check whether there is any sign of inflammation or if there is any change in the endometrium. This test is rarely performed as it cannot help with infertility diagnosis and treatment.

3. Luteinizing Hormone (LH)

The level of this luteinizing hormone indicates the presence or absence of ovulation. There is a kit called the ovulation predictor kit (OPK), which detects the luteinizing hormone and is very effective.

4. Ultrasonography

This ultrasonography uses a sound wave to get the image. And then examine the uterus, ovaries, endometrium, and ovarian follicles. The imaging test is done via the women’s abdomen or vagina. This is also done to look for signs of ovulation, such as smaller follicle size, loss of clear follicles, fluid in the follicle sac, and sufficient endometrium thickness.

5. Ovarian Reserve Test & Health Test

The following diagnostic tests for infertility tests are done to check the health of ovaries and ovarian reserve: –

An ovarian reserve test is done when a woman is 33 years of age or older. Or if the woman has other risk factors such as a family history of early menopause, signs of premature ovarian failure, being a cigarette smoker, ovarian or extensive pelvic surgery, recurrent pregnancy loss, etc.

6. Laparoscopy

Laparoscopy is an surgical procedure in which a thin, lighted tube called a laparoscope is used to see and examine the uterus, fallopian tubes, ovaries, and pelvic surfaces. The appearance of follicular cysts and skilled fluid sacs on the ovaries are common signs of ovulation.

7. Other Endocrinology Tests

Following are the other endocrinology tests performed for women: –

Pelvic Disorders Test

Following are the tests done for diagnosing pelvic disorders: –

1. Ultrasound and Sonohysterography

Doctors perform an ultrasound to visualize the organs’ structure and detect any abnormalities in the pelvic region associated with infertility, such as a blocked fallopian tube.

And sonohysterography is used to detect a problem in the pelvis and ovaries. It is a unique ultrasound technique that checks inside the uterus to find abnormalities like scar tissue, fibroids, or polyps.

2. Hysterosalpingogram

It is a radiology procedure that examines the uterus and fallopian tube health. In this, a radio-opaque fluid is injected into the uterus and fallopian tubes. Then to check the uterus shape for fibroids and scar tissue, a photograph via x-rays is taken and whether the tubes are blocked. It is a relatively simple, safe, inexpensive, and reliable test. However, it can cause cramping in some women.

3. Hysteroscopy

It is done to examine and check for abnormalities such as polyps, fibroids, scar tissue, or other abnormalities inside the uterus.

4. Magnetic Resonance Imaging (MRI)

It is helpful in some the situations, such as identifying lesions or rare abnormalities inside the pelvis and uterus.

5. Laparoscopy

It is used to look for abnormalities inside the pelvis. It is generally accurate in diagnosing infertility. This is used to treat problems such as scar tissue, endometriosis, ovarian cysts, fibroids, and endometriosis, a condition in which uterine lining tissue grows outside the uterus.

Cervix Related Test

Following are the tests done to examine the cervix: –

1. History of Sexual Intercourse

The fertility specialist will ask questions related to your sexual intercourse. These questions may include the frequency and timing of intercourse. They may also request additional questions such as lubricants, ejaculatory problems, and other issues. It may also have your sexual history, including cervical and vagina orations and other surgeries.

2. Tests for Sexually Transmitted Disease (STD)

A fertility specialist may perform tests like HIV1, Hepatitis B, Hepatitis C, Syphilis, Chlamydia, and Gonorrhea.

3. Post-Coital Test

A post-coital test is done to inspect the interaction between sperm and cervical mucus. This is done to examine cervical mucus within a few hours of sexual intercourse. However, fertility doctors have stopped using the test.

4. Antisperm Antibody Tests

These are rarely in use now because they do not predict pregnancy. The woman’s immune system may produce proteins that attack sperm (anti-sperm antibodies). In men’s sperm, doctors test for these proteins. They can also check if the partner’s sperm can move through a woman’s cervical mucus to reach the fallopian tubes. 

Diagnostic Test for Male Infertility

To diagnose the cause of infertility in men, the doctor may perform the following tests: –

Sperm and Semen Analysis

Fertility specialist in men first checks the sperm count, its shape, movement, and other features. If one has more of a normal shape, sperm means high fertility. But still, there are some exceptions.

If the first semen analysis report is normal, you will be recommended for a second test to confirm the result. And if you one does not have any sperm, it may be because of a blockage in plumbing and can be corrected with surgery.

Physical Examination

Doctors will perform a physical examination of one reproductive organ to find if there is any abnormal formation of veins above the testicles, which are called varicoceles. These varicoceles can result in infertility in men but can be corrected with surgery.

Hormone Evaluation

Hormones are not the primary cause of infertility in approx. 97% of infertile men. However, doctors perform testosterone and other hormone evaluation which control the making of sperm.

Genetic Testing

Genetic tests and testicular mapping like the cystic fibrosis test, karyotyping, and Y microdeletion analysis are essential for male infertility diagnosis tests for couples who are at risk of inherited genetic diseases. This test is done to identify the specific obstacles to fertility and problems with your sperm.

Anti-Sperm Antibodies

Few men develop abnormal antibodies which stop the sperm on its way to the egg. Thus, pregnancy does not occur.

And for some other men making sperm is not the issue. The problem is with getting the sperm where it needs to go. Men having such trouble have normal sperm in their testicles, but either it is low in numbers or abnormal, or sperm in the semen is missing. Having low sperm in the semen can be because of various reasons, such as-

Conclusion

If you face difficulty conceiving, don’t hesitate to get diagnosed with your infertility issue. Both men and women should undergo the diagnosis as this helps in knowing the exact problem and treatment available.