Female fertility tests
One of the aims of the primary tests you'll have is to find out whether or not you are ovulating. If you are, the fertility clinic will start a range of more advanced tests to discover why you haven't been able to conceive. These tests will check the condition of your hormones, ovaries, uterus, and Fallopian tubes and look at how well they're functioning.
Hormone and ovulation tests
© DK
Measuring the levels of hormones in your blood during your menstrual cycle can give useful information. Generally levels are checked during the first three days of your cycle and again seven days before your period is due. The measurements show how your ovaries, brain, pituitary, and hypothalamus are interacting, and highlight any imbalance in your hormones that may be causing a problem with ovulation. Usually, your oestrogen, progesterone, and luteinizing hormone (LH) levels are measured and compared to normal ones. Other hormones that can affect a woman's ability to ovulate are follicle-stimulating hormone (FSH), testosterone, and prolactin, so blood levels of these will also be checked.
Ultrasound scanning tests
With a simple scan your fertility specialist can check the development of your ovarian follicles and confirm that you're ovulating. Tracking of the follicle in this way is important if you're taking drugs to stimulate ovulation, as it can help avoid overstimulation, which can be dangerous. Your doctors will also want an accurate assessment of your follicular growth if they need to perform complex assisted conception procedures such as in vitro fertilization (IVF).
Endometrial biopsy
Under the influence of oestrogen and progesterone, the endometrium (lining of the uterus) changes through the menstrual cycle. There's a dramatic endometrial thickening and growth during the first half of the menstrual cycle before ovulation, because of the increased amount of oestrogen in the body. But if not enough oestrogen is made, the endometrium may not be sufficiently developed to allow the embryo to implant successfully. In a biopsy, a tiny sample of your endometrium is taken during the second half of the menstrual cycle. It's examined under a microscope when any changes that are caused by hormone levels will be visible.
Fallopian tube tests
The fallopian tubes are extremely delicate structures. Less than 4mm (1/8 in) in diameter at their narrowest, they are easily damaged. Up to one-third of all of the women who attend an infertility clinic are found to have a problem with their Fallopian tubes. Once the primary tests have been completed, there are a number of tests that are carried out to check the Fallopian tubes. These tests are among the first investigations made when an infertile couple attend a specialist clinic.
Hysterosalpingogram
Also known as HSG, this is an X-ray picture of the uterus and tubes, which can show up problems inside them. A special dye that can be monitored on an X-ray screen is slowly injected into the uterus and should pass into the Fallopian tubes. If it fails to do so, there may be some damage, distortion, or blockage in the tubes.
Laparoscopy tests
This is one of the most useful tests for finding out whether a woman's tubes are damaged or blocked. The laparoscope is a slender telescope - only about the width of a fountain pen - that uses fibreoptics to look directly into your abdominal cavity. It gives a superb view of all the organs, allowing your surgeon to assess their health and giving information on adhesions, endometriosis, and ovarian disease. High-quality videos can also be taken through the laparoscope so that your doctors can refer to them later. Although you'll need to have a general anaesthetic, laparoscopy can usually be done as a day procedure.
Posted 16.11.2010
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