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: –

1. 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.

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: –

  • Test for Follicle Stimulating Hormone (FSH) – the hormone inside the pituitary gland is known as a follicle-stimulating hormone. Its level increases as the number of eggs decreases. So, with growing age, its level increases. It is checked between the 2nd and 4th day of the menstrual cycle.
  • Estradiol Test– It is a hormone produced by the ovary. Its level below 85picograms/mL is considered healthy. In contrast, higher levels indicate problems in ovulation.
  • Anti-Mullerian Hormone (AMH) Test -It is done anytime during the menstrual cycle. This hormone is made inside the follicles. Its level decreases with age as the number of follicles decreases.
  • Clomiphene Citrate Challenge Test (CCCT)- This a test in which a doctor checks both FSH and estradiol levels during the 2nd and 4th day of the menstrual cycle.
  • Ultrasound– It is done to diagnose the decreased ovarian reserve. And to check the number of antral follicles in the ovaries.

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: –

  • Thyroids Stimulating Hormone
  • Prolactin Hormone
  • Androgen Hormones

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.

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-

  • Retrograde Ejaculation:- It is a condition in which sperm ejaculates backward into the bladder.
  • Vas Deferens/Sperm Duct:-It is a genetic problem in which the main sperm pipeline is missing. There can be any blockage between the testicles and the penis.
  • Anti-Sperm Antibodies:- It is a condition in which they do not allow sperm is on the way to the egg.

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.