Tests

The causes of infertility are complex, and finding the cause of one couple's problems requires a thorough evaluation of both partners.

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The first step is a visit to the doctor for a thorough physical examination and medical history, for which the doctor will ask about both partners' personal health backgrounds and sexual histories--how often they have intercourse, for example, and whether either has been pregnant or caused a pregnancy before. For example, if the woman has had children with a previous partner but the man has never caused a pregnancy, even though he's had opportunities, that is a hint that the infertility might be due to a problem with the man.

Women often undergo blood tests for reproductive hormones and an ovarian ultrasound as the first step. There is no way to count the number of eggs a woman has left, but these tests can give an idea of the health of her ovaries, or her ovarian reserve--the chance that her ovaries are going to be able to produce a healthy egg. Depending upon the history and examination, a laparoscopy, hysteroscopy, or hysterosalpingogram (HSG) may be performed to further evaluate the reproductive anatomy. For men, a semen analysis is a standard first step, and a testicular biopsy can give more information about a poor sperm count. Patients may want to try tracking their ovulation at home.

Even an exhaustive and thorough evaluation by skilled professionals may not identify a reason for the failure to conceive or carry a successful pregnancy. Unexplained infertility is one of the most frustrating diagnoses for both patients and physicians.

This section contains more on:

Semen analysis

Testicular biopsy

Home test for ovulation

FSH tests

Ovarian ultrasound

Endometrial biopsy

Hysterosalpingography

Laparoscopy

Other tests