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The 6 Tests to Try if You’re Struggling With Infertility

Having difficulty conceiving a baby is not uncommon for many women. But your doctor can easily evaluate your fertility and identify a course of action. Here are the common tests in an infertility workup, from Our Bodies, Ourselves, by The Boston Women’s Health Book Collective.

An infertility workup tests all the links in the chain of events from ovulation to an established pregnancy in an orderly way. It can take as long as six to twelve months, because many tests have to be scheduled at specific times in your cycle and can’t be combined. Some of these tests for women are invasive, painful, and emotionally exhausting. Workups are expensive, and unfortunately, medical insurance coverage can be limited, even for infertility diagnosis. Though the sequence of diagnostic tests may vary with different doctors or clinics, it can include some or all of the following:

A general and medical history of you and your male partner, if you have one. This will include a review of your menstrual history and the nature of your menstrual periods, as well as details about any previous pregnancies, episodes of STI, or abortions; your use of birth control; DES exposure; sexual relations (frequency and position); where you live and whether your job has exposed you to any toxins that may have affected your reproductive system; and behavioral factors, such as stress, nutrition, smoking, drinking, and use of drugs (both prescribed and “recreational”). Before starting your infertility workup, have toxoplasmosis screening done and get tests to determine if you’ve been exposed to chicken pox (varicella), German measles (rubella), and HIV.

A gynecologic examination, primarily to check your uterus, ovaries, breasts, and general pelvic area.

Monitoring ovulation. A thorough practitioner will make sure you understand your menstrual cycle, and will help you track your ovulation, usually by taking your basal temperature every morning or by using a urine test kit.

Hormonal profile. You will need blood tests to check levels of all hormones that relate to your menstrual cycles, ovulation, and fertility, as well as the levels of your thyroid hormones.

Ovarian reserve. This term refers to the capacity of the ovaries to grow healthy eggs that can ovulate and be fertilized. Doctors can evaluate ovarian reserve in two ways: by checking blood levels of the hormones inhibin B and FSH on cycle day three; and by using daily ultrasound scans to observe the number and size of the growing follicles (balls of cells in the ovary containing eggs).

Semen analysis. The man will be asked to ejaculate semen into a clean container, and the specimen will be examined under a microscope to assess sperm count, shape, and motility. If either the motility or the shape of the sperm is abnormal, additional tests may be done. The American Society for Reproductive Medicine website (www.asrm.org) provides patient fact sheets describing these tests and the expected range of results for them. Because a man’s sperm can fluctuate in count and motility for many reasons, he may be asked to repeat the semen analysis at least every six months. If the result is abnormal, your male partner or sperm donor should pursue his own diagnosis before you have further tests done.

ABOUT THE AUTHOR
Author of Our Bodies, Ourselves (Copyright © 2005 by the Boston Women’s Health Book Collective), The Boston Women’s Health Book Collective aims to empower women by providing information about health, sexuality, and reproduction. Advisory board members include Teresa Heinz Kerry, Susan Love, and Gloria Steinem. To learn more visit www.ourbodiesourselves.org.

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