When should I take a fertility test?

For two people to conceive a child, both partners' bodies need to make a contribution. A woman's fertility is tested with a variety of lab tests and medical tests.
For two people to conceive a child, both partners’ bodies need to make a contribution. A woman's fertility is tested with a variety of lab tests and medical tests.

For two people to conceive a child, both partners’ bodies need to make a contribution. However, if you and your partner are trying to conceive but have been unsuccessful for a year or more, both the male and the female partner should get their fertility tested. As a female, there are many tests that you are able to take.

You should take a test if you have not become pregnant after a year of having unprotected sex while not on birth control. However, it may also be appropriate to get tested earlier if:

  • You are old than 35 
  • You experience irregular menstrual cycles or a pattern of skipped menstrual cycles
  • You have had issues with your uterus, tubes, or abdominal cavity

What fertility test should I take?

You should look at fertility testing in a focused way where you can slowly analyze all the potential factors. Your partner should also be concurrently taking fertility tests with you. You should try to start with the least invasive tests first. However, the most important thing is to tailor your testing to your unique situation, medical history, and time frame.

Some of the steps that are taken and the tests that are generally considered first are:

  • Both partners should start by talking through their medical history with their healthcare providers. You will need to answer questions about your sexual history, sexually transmitted diseases, medications, birth control, use of caffeine, alcohol, and drugs. You will also answer questions about your menstrual cycle, and your doctor may order a test for sexually transmitted diseases. 
  • In addition to a medical history exam, you will also need to take a physical exam. Usually, this will include a pap test and a pelvic exam. For men, there will be a testicular examination. 
  • You will then need to take urine tests, specifically when you are on your menstrual cycle so that doctors can test your levels of luteinizing hormone and progesterone. Urine tests can also be used to test your thyroid, thyroid-stimulating hormone, and prolactin levels. If you have an irregular cycle, you may also want to test your urine for prolactin, a hormone made in your pituitary gland
  • Specific blood tests may also be necessary for you. Specifically, a blood test for an anti-mullerian hormone can be used to test your ovarian reserve or your egg supply. You may also want to take a follicle-stimulating test for the same information. 
  • Some types of testing for sexually transmitted infections can be done on urine samples or samples from the urethra or cervix. 
  • Many women also will be asked to perform home urine tests in addition to those conducted at the clinic. This way, you can test the fluctuations in your body temperature as well as get more precise information about your menstruation

If you take all of these tests and still do not find a cause, you could also take the following tests:

  • Pelvic ultrasound. This test can create an image of your uterus and ovaries’ size, shape, and structure. It can tell you about the condition of your uterus and ovaries, as well as your ovarian reserve. It may be prudent to take this test specifically during your menstrual cycle. 
  • Hysterosalpingogram. If you and your provider feel that it may be a good idea to take a look at the inside of your uterus and fallopian tubes, this imaging test can show blockages in the fallopian tubes and explain why an egg might have trouble reaching the uterus. It can also pick up on issues of your uterus’ shape or other issues that could prevent eggs from being fertilized. 
  • Sonohysterogram. This test uses saline solution in combination with an ultrasound to get a better picture of your reproductive system as a whole. 
  • Laparoscopy. While this is technically a test, it is also a procedure that you undergo under general anesthesia. It involves your healthcare provider making a small incision into your belly and then shining a light into your pelvis. This way, they can examine you to find cysts, scar tissue, fibroids, and infections. This procedure can also be done to treat endometriosis

If you remain unable to figure out what may be causing your infertility, you could take these tests:

  • Antibody blood tests. These tests can pick up on antisperm elements in someone’s blood or genital fluids. These tests are controversial within the healthcare community, so proceed with caution. 
  • Chromosome or genetic testing. There are some genetic disorders that can interfere with your ability to become pregnant and carry a child to term. To test for these disorders, you can either take a chromosome analysis or a genetic test. 
  • Hysteroscopy. These tests are ordered to look at urine lighting. They are performed by putting a small lighted scope in your vagina. Your doctor may also take out growths or samples from your fallopian tubes during this test. 

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Medically Reviewed on 10/22/2021
References
SOURCES:

American Pregnancy Association: "Fertility Test for Women."

ReproductiveFacts.org: "Diagnostic Testing for Female Infertility."

University of Michigan Health: "Infertility Tests."