8 Common Fertility Tests For Women
If you’re young, healthy and have no real family history of infertility but have struggled to get pregnant for a while, it may be time to see a fertility specialist.
Your GP will be able to refer you to a suitable specialist who will speak with you and your partner about your pregnancy journey so far, with the aim of helping you to find out why you’ve struggled to get pregnant.
Once they have a good idea of you and your partner, and your respective medical histories, they’ll probably conduct one, if not multiple, fertility tests to try and really pinpoint the underlying cause for your pregnancy delay.
Below are some of the more common fertility tests they may carry out and what each involves:
#1 Blood Tests
A blood test will likely be the first and foremost test your doctor orders, and they may arrange for a number to be taken on different days of your monthly cycle.
Through this your doctor can check your female hormone levels and thyroid hormones – both of which contribute towards your fertility. Further blood tests can check other specific hormone levels such as Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). These typically take place in the middle of your cycle to check for ovulation. After your ovulation your doctor may also carry out further blood tests to check for Estradiol and Progesterone for comparison.
#2 Cervical Mucus Test
Sometimes the cervical mucus can prevent pregnancy. Your doctor may order a test for this, as well as a Post-Coital test. The female body produces a naturally occurring spermicide which interacts with your partner’s sperm and prevents it from fertilising your egg, so it may be a good idea to check this out.
Both of these tests will check check for the quality and consistency of your cervical mucus, as well as how your partner’s sperm is interacting with it and could provide valuable information on why you have struggled to get pregnant. Your cervical mucus also changes throughout your monthly cycle, so it is likely your doctor will ask for a couple of tests throughout the month for comparison, particularly close to your ovulation dates.
This is a non-invasive test your doctor will ask you to carry out yourself and discuss further with you.
#3 Clomiphene Citrate Challenge Test
This test will check your ovarian reserve, which is essentially an estimate of your potential for pregnancy. A low ovarian reserve could be a strong indication of why you’re unable to get pregnant and help your doctor plan next steps.
The test is basically a comparison test that also involves you taking a fertility drug – clomiphene citrate. The drug stimulates your ovaries to release eggs. There are three steps to the test:
1. Your doctor will test your FSH and Estradiol levels on the third day of your cycle
2. You will then be asked to take clomiphene citrate from day 5 to day 9 of your cycle
3. Your doctor will retest your FSH and Estradiol levels on day 10
#4 Hysterosalpingogram (HSG)
Once your doctor has checked for various hormonal imbalances, the next step will be to check for any physical causes surrounding your fertility. A HSG is an x-ray that will allow your doctor to see inside your fallopian tubes and your uterus. Essentially your doctor is looking to see whether there are any blockages in your fallopian tubes that may be preventing your eggs from fertilisation. Blocked fallopian tubes are one of the most common reasons for infertility. The x-ray is enhanced using dye:
1. Your doctor will inject a dye through your cervix and into the uterine cavity
2. The dye will be unable to enter your fallopian tubes if they are blocked
3. Your doctor will take an x-ray so they can examine whether the dye has been able to move into the fallopian tubes
This test is also beneficial as it can show up any other physical causes that could be behind your infertility such as polyps or fibroids.
If the HSG shows up any blockages, or other physical causes that could be behind your fertility troubles, then your doctor may order a further test called a laparoscopy. This is a very short, minimally invasive surgery that will give your the doctor a chance to see what’s really going on in your uterus and fallopian tubes. The surgery generally involves:
1. A small laparoscope (a small tubular telescope) is inserted into your abdomen and uterus
2. Your doctor will make small incisions to better see your uterus, fallopian tubes, and ovaries and check them for abnormalities
3. Depending on what the HSG showed up, your doctor can treat any blockages or other damage while conducting the procedure
The procedure is very low risk and recovery time is the standard for any minor surgery – generally 4-6 weeks.
This procedure is fairly similar to the laparoscopy, but your doctor will be focusing more on your uterine cavity rather than your ovaries and fallopian tubes. This procedure allows your doctor to check for any physical abnormalities in the uterine cavity that could be having an impact on your ability to fall pregnant. It generally involves:
1. A thin hysteroscope (a small tubular telescope) is inserted through the cervix and into your uterine cavity (uterus)
2. Your doctor will check the area for any physical abnormalities or damage such as fibroids, scar tissue, polyps or anything else that looks unusual
3. Depending on what your doctor thinks may be needed, the procedure can be carried out while you’re awake or under general anesthetic
This is another low risk procedure, with very minimal recovery time, depending on how it is conducted.
#7 Saline Hysterogram (SHG)
The SHG is a much less invasive procedure and your doctor is again checking your cervix and uterine cavity for any physical inconsistencies, rather than your ovaries and fallopian tubes. You might also hear this procedure referred to as a ‘water ultrasound’ and it involves:
1. A saline solution is injected into your cervix and uterus
2. Your doctor will use an ultrasound to scan your abdomen and check how the saline interacts with your uterine walls
3. Your doctor will be able to pick up on any abnormalities such as fibroids or polyps
There is no necessary recovery time for this procedure and you will be awake while your doctor conducts the scan and talks you through what is happening.
#8 Endometrial Biopsy
An endometrial biopsy is similar to any other biopsy you might undertake – it is where your doctor takes a small tissue sample in order to study it for any menstrual or hormonal conditions that could be behind your infertility. This is a very minor surgery and general involves:
1. After checking that you are definitely not pregnant, your doctor will check your cycle and arrange for biopsy to be taken a week before your period is due to begin
2. Your doctor will take a sample of tissue from your endometrium (the inner uterine lining) for testing
Similar to a smear or PAP test, some women experience slight pain or cramping after this procedure.
What if my fertility tests show abnormalities?
Don’t panic! The whole purpose of carrying out fertility testing is to narrow down where or what the underlying causes are for you being unable to get pregnant. If your doctor does find a cause, that’s a good sign!
It means your doctor knows what’s wrong and plan the next steps of your fertility journey to help you on your way to getting pregnant.
Fertility tests are designed to bring closure and comfort and help you and your partner move forward. Your doctor is always on hand to discuss what is usually a very emotional rollercoaster for their patients, so remember to always speak with them and take advantage of the counselling they will likely have available if you are finding it a bit too stressful.