What is Infertility testing?

Infertility testing is a set of medical evaluations used to determine the underlying causes of a couple’s inability to conceive after one year of regular, unprotected intercourse (or after 6 months if the woman is over 35).

Testing involves both male and female partners since infertility can stem from issues with either or both.

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Infertility Testing Overview

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♂ Male Infertility Testing

1. Semen Analysis
   •    Purpose: Evaluate sperm count, motility (movement), morphology (shape), and volume.
   •    Most common initial test for male fertility.

2. Hormone Testing
   •    Blood tests for testosterone, FSH, LH, prolactin, and thyroid hormones.

3. Scrotal Ultrasound
   •    Detects varicoceles (enlarged veins), blockages, or abnormalities.

4. Genetic Testing
   •    Performed if sperm count is very low or absent (azoospermia) to identify Y-chromosome microdeletions or Klinefelter syndrome.

5. Testicular Biopsy
   •    May be done to determine if sperm are being produced in men with azoospermia.

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♀ Female Infertility Testing

1. Ovulation Testing
   •    Blood tests for progesterone (done in the mid-luteal phase).
   •    LH surge detection kits (home urine tests).

2. Hormone Testing
   •    Blood tests for FSH, LH, estradiol, prolactin, TSH, and AMH (anti-Müllerian hormone, to assess ovarian reserve).

3. Transvaginal Ultrasound
   •    Examines ovaries and uterus.
   •    Can evaluate antral follicle count, fibroids, polyps, or structural anomalies.

4. Hysterosalpingography (HSG)
   •    X-ray test with contrast dye to evaluate fallopian tube patency and uterine shape.

5. Sonohysterography or Hysteroscopy
   •    For direct visualization of the uterus to check for polyps, fibroids, or scarring.

6. Ovarian Reserve Testing
   •    Measures how many eggs a woman may have left (AMH, FSH, estradiol, antral follicle count).

7. Laparoscopy
   •    A surgical procedure to look for endometriosis, adhesions, or tubal issues.

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 When Should Testing Start?
   •    After 12 months of trying for women under 35.
   •    After 6 months for women 35 or older.
   •    Immediately if there’s a known issue (irregular periods, prior pelvic infections, testicular surgery, etc.).