Evaluation of Female Infertility
Other aspects of your health that need to be considered include:
- Medical history – do you have a known genetic disorder, trouble with your hormones, or have you had infections of your reproductive tract (pelvic inflammatory disease)?
- Medications – for example, are you taking any hormones?
- Potential sexually transmitted diseases – have you been exposed to any STDs or had symptoms of genital inflammation, such as vaginal discharge, pain with urination, abdominal pain, or fever together?
- Substance use – do you use or abuse any medications or drugs, including caffeine and cigarettes?
- Surgical history – have you had surgery involving your bladder, uterus, Fallopian tubes, ovaries, cervix, or anything else in the area?
- Toxin exposure – have you been exposed to chemical or radiologic toxins?
The doctor will do a physical examination to make sure that all your reproductive organs appear to be normal and that your hormonal status seems normal.
If necessary, the doctor will order tests to check for ovulation as previously mentioned. Other laboratory tests depend on what all of the above reveals. If there is a problem with ovulation, there are a number of hormonal tests that will be checked. There may be specific tests done on day 3 of your cycle to see if follicles seem to be developing. Some women may need ovulation to be stimulated with medication to see if their ovaries can develop follicles. Sometimes an ultrasound via the vagina can actually show developing follicles.
If there does not seem to be another problem, or if your history suggests you might have scarring, the final test may be an evaluation of your reproductive tract to make sure there is no scarring and that there is a clear pathway for eggs and sperm. This is usually done by hysterosalpingogram, an x-ray test using dye. This can be followed if necessary by direct observation via laparoscopy, looking into the abdomen, or hysteroscopy, looking into the uterus.
After all of these tests have been done, the doctor will be able to tell you if he or she has found a cause for your infertility, and if so, what can be done to treat it.