Diagnosing Infertility
In the United States, 11% of women of reproductive age have experienced fertility challenges. This can be a scary statistic if you're trying to grow your family. Luckily, diagnostic tests and assessments can provide a clearer picture of your fertility and offer guidance for the next steps in your family planning journey.
Below, we will explore what female infertility is, identify who should get their fertility tested, and explain the diagnostic methods used.
What is Infertility?
The American Society for Reproductive Medicine defines infertility as a condition characterized by any of the following factors:
Inability to achieve a successful pregnancy due to medical, sexual, or reproductive history, age, physical findings, diagnostic tests, or a combination of these.
Need for medical intervention, like donor gametes or embryos, to achieve pregnancy, alone or with a partner.
Inability to conceive after regular unprotected sex with a male partner for twelve months in women under 35 and six months for women over 35.
Who Should Get Their Fertility Tested?
Most couples will conceive within their first six months of trying. So, if you're young, healthy, and having a regular menstrual cycle, you may not need fertility testing. But, if you're younger than 35 and tried for a year without success, or if you're over 35 and tried for six months without getting pregnant, it's time to discuss fertility testing with your doctor.
Additionally, if you have a medical condition that may make it challenging to conceive, such as irregular menstrual cycles, consider undergoing fertility testing earlier, regardless of your age or the duration of trying to conceive.
Conditions that can lead to infertility in women include the following:
Ovulation disorders
Damage to fallopian tubes
Endometriosis
Uterine or cervical issues
Genetic disorders
Sometimes, doctors never find the cause of infertility. This is known as unexplained infertility and can be an incredibly frustrating diagnosis. While it’s challenging to not have an answer, don’t lose hope. Work with your doctor to explore fertility treatments and learn about your family-building options.
How is Infertility Diagnosed?
If you are struggling to conceive, your doctor may perform several tests to help identify the cause of your infertility and determine next steps for treatment. Diagnosing infertility in women may require one or more of the following assessments.
Review Medical History and Perform a Physical Exam
At your initial visit, your doctor will ask questions about your reproductive health, sexual history, and family history. This information helps healthcare providers identify potential underlying conditions or genetic factors affecting fertility. They may also perform a physical examination to help identify abnormalities or signs of a hormonal disorder.
Ovulation Testing
Ovulatory dysfunction is one of the leading causes of infertility, affecting approximately 15% of all infertile couples and up to 40% of women struggling to conceive. Since ovulatory dysfunction impacts so many women, your doctor will likely want to perform a blood test to measure your hormone levels and discover whether you're ovulating.
Thyroid Function Test
If your doctor suspects that your infertility is linked to issues with your thyroid gland, they may perform a thyroid function test. Having too much or too little of the thyroid hormone can cause menstrual irregularities, repeat miscarriages, and problems with fertility.
Ultrasound
A healthcare provider typically performs ultrasound exams for women experiencing infertility by inserting a slim ultrasound probe into the vagina. This allows your doctor to check for pelvic abnormalities like fibroids or ovarian cysts.
Hysterosalpingogram
A hysterosalpingogram (HSG) is an X-ray dye test that allows your doctor to view the inside of your uterus and fallopian tubes. Open fallopian tubes provide a clear path for sperm to travel and fertilize an egg. However, blockages, scarring, or abnormalities can prevent this process from happening, leading to infertility.
Saline Sonohysterogram
If you're experiencing abnormal uterine bleeding, infertility, or recurrent miscarriages, your doctor may perform a saline infusion sonohysterography (SHG). This procedure helps detect abnormalities using an ultrasound and a sterile saline solution to show the uterus and uterine lining.
Hysteroscopy
A hysteroscopy is a minimally invasive procedure that allows your healthcare provider to examine the inside of your cervix and uterus using a thin, lighted camera. This procedure makes it easier to view and diagnose polyps and fibroids. Your doctor may also use a hysteroscopy to repair abnormalities in the uterine wall.
Laparoscopy
If other tests fail to provide a conclusive infertility diagnosis, your doctor may perform a laparoscopy. This minimally invasive surgical procedure involves inserting a telescope-like instrument (laparoscope) with a small light and camera through two or more minor incisions on the abdomen. This procedure allows your doctor to examine your uterus, fallopian tubes, and ovaries internally. Your doctor may also use an operative laparoscopy to remove scar tissue or endometriosis.
Genetic Testing
Genetic factors like inherited chromosome abnormalities and genetic disorders can impact fertility. Genetic testing helps determine if you have a genetic condition that might be affecting your ability to conceive, allowing for more targeted and effective treatment options.
Partner Semen Analysis
Infertility doesn't just impact women. Men are found to be solely responsible in 20-30% of infertility cases. For this reason, if you have a male partner, your doctor may request samples of his semen. A lab will then analyze the quantity, movement and shape of sperm in the semen. If the results are abnormal, additional testing may be needed.
Your Fertility Partner
Navigating infertility can feel discouraging and overwhelming. You shouldn't have to do it alone. At Beverly Hills Reproductive Center, we provide personalized fertility testing and family-building services. If you want to learn more about our practice, please contact us. We're eager to help you build your family.