The Low-down on Infertility Testing

Have the two of you made the choice to go see the doctor then? Heck, I’d be a bit nervous too – especially with not knowing what to expect! In general the tests are relatively predictable, so it’s quite straightforward to get an accurate idea of what to anticipate. At your preliminary consultation the doctor will have a whole bunch of questions with reference to your sexual and medical history, so be ready! The doc will generally start with the least invasive tests and move onto the more invasive procedures if the intial tests don’t give any indication of what is wrong.

Ladies first:

· Blood and urine tests – You could have to do a few urine tests throughout the month to check if you’re ovulating. These could also be used to test for thyroid problems or to see if you have too much prolactin – the hormone that directs your body to produce milk and not ovulate – not good news if you don’t have a baby yet! The test will also check if you have any STDs.

· Postcoital test – Even though this test isn’t used much these days it involves having sexual intercourse the day before you ovulate and then going for an internal examination within a short while. This is to verify if the sperm are doing okay and moving in the right direction.

· Pap smear – The doctor takes tissue samples from the opening of the cervix (the os) to check for cervical cancer.

· Pelvic Examination – Also called the bimanual examination – two fingers out, two fingers in. The doc may also use a speculum – a device to look inside – and may also take swabs for screening.

· Pelvic Ultrasound – Checks the ovaries and uterus for any abnormalities.

· Laparoscopy – The doctor makes a little cut on the abdomen to insert a miniature camera to look for scars or cysts or other visible problems – it may seem really sci-fi, but you’ll probably be under anesthetic so you won’t even see what’s happening.

· Sonohysterogram – Similar to an ultrasound but saline solution (salt water) is squirted into the uterus. This is used to screen for any structural problems.

· Hysterosalpingogram – Fallopian tube blockages can be checked (and sometimes even cleared) by injecting fluid that shows up on X-ray into the uterine cavity.

· Endometrial Biopsy – A sample of the uterine lining is taken to observe changes.

· Antibody test – This is a blood test to look if your immune system is slaughtering the sperm before they get to the egg.

· Hysteroscopy – Similar to a laparoscopy, except that the camera goes in through the vagina.

For the men:

· Blood tests – To check FSH, LH and testosterone levels to check if the guy has a pituitary gland problem, and also to screen for STDs.

· Semen analysis – This involves ejaculating into a sterile container provided by the doctor, at the doctor’s rooms or at home. They’ll want to find that there are lots of well-built spermies that are moving well.

· Testicular Examination – Generally this test forms part of the general physical and the doctor will check for large veins on the scrotum that overheat and damage spermies.

· Antibody test – To check that your immune system isn’t killing the sperm before they even make it out the door.

· Ultrasound – Testicular abnormalities may be checked by ultrasound scanning.

· Testicular Biopsy – The doc will take a sample of tissue from the testicles to see if they have sperm, especially if the semen doesn’t have any sperm in it.

Genetic testing can help to locate any hereditary conditions that increase the chances of infertility. So quite a few of the tests are really simple and your doctor may be able to do them at your initial visit, but if those don’t help you’ll need to go for extra testing which may necessitate surgery or other procedures. It may become fairly expensive so it is generally best to go for the simple tests first! The awkwardness of having someone inspecting your privates makes the physical discomfort even worse, but many of the tests are not uncomfortable in the least.

With any luck, all that infertility testing will give you some idea of the reasons for you infertility and then you can make the next move of doing something about it. But on the other hand, after all that testing you might still have no idea what is going on and that can be quite hard. You’ll generally find that the infertility clinic you go to will have support available – and it’s probably a good idea to take advantage of it whether you know what the problem is or not.

Here is more information on Reasons for Infertility. Here is a website with a free mini-course dedicated to Infertility.