Your doctor will ask about your medical history, including details on:
You’ll also discuss your diet, exercise habits, work environment, and current sexual practices.
In order to become pregnant, a woman must have working ovaries, fallopian tubes, and a uterus. Your doctor will need to examine your body and perform a series of tests to identify reproductive system conditions or abnormalities that may be contributing to fertility challenges.
Procedures may vary by clinic, but will likely include:
Weight and body mass index (BMI) will be measured. Your doctor will also inspect your face and body for unusual hair growth patterns, which could point to a possible increase in male hormones that affect fertility.
Your doctor will inspect the shape and size of your uterus, and check your cervix for growths, sores, or infection. Discharge and cervical mucus may also be examined. If a routine cervical screening (pap smear) hasn’t been done recently, a new test may be performed to check for abnormal cell growth.
The shape and size of your breasts will be examined. Your doctor may also squeeze your breasts to check for liquid discharge, which could indicate high levels of a hormone called prolactin that can keep you from ovulating.
The size of your thyroid will be checked for any abnormalities.
Your doctor may test for rubella (German measles), chlamydia, hepatitis B and C, and human immunodeficiency virus (HIV). Depending on your heritage, you may also be tested for diseases or disorders that are more common among certain ethnic groups, such as sickle cell anemia or cystic fibrosis.
These tests, some routine and others investigational, vary from clinic to clinic. Ask your doctor for more information about what you can expect.
Your doctor may conduct ultrasounds throughout your menstrual cycle to examine the condition of your uterus and ovaries. Ultrasound may be used to monitor the thickness of the lining of the uterus, whether or not you’ve ovulated, and the growth of follicles (immature eggs) in your ovaries.
Depending on the results from your preliminary discussion and examination, your doctor may order additional fertility tests and procedures to get a better picture of how your reproductive system is functioning.
These tests help determine if you are ovulating, and the quality and quantity of the eggs you produce (also known as your ovarian reserve). This can help predict how your ovaries will respond to infertility treatment cycles in the future.
Blood tests include:
Higher levels may indicate a decrease in the production of quality eggs. Taken on day 3 of your period.
An increase may indicate a decrease in egg quality. Taken on day 3 of your period.
Inhibin B is a potential marker for ovarian function and follicular content. Low levels have been associated with a decreased response to certain infertility treatment medications. Taken on day 3 of your period.
High levels indicate that ovulation has occurred. Taken approximately one week prior to expected period.
Your doctor may also conduct additional lab work to measure the amount of luteinizing hormone (LH), prolactin, androgen, anti-mullerian hormone (AMH), and thyroid stimulating hormone (TSH) in your blood.
This internal ultrasound scan is used to monitor the number and size of follicles present in the ovaries.
Your doctor will use colored dye and an X-ray to check the shape and size of your uterus and fallopian tubes. This test is used to identify tubal blockages or cysts.
This test is used to diagnose or treat problems in the uterus. Through your vagina, your doctor will insert a tiny, lighted telescope that projects images of your uterus onto a screen. Endometrial biopsy—the removal of a small piece of tissue from the lining of the uterus—may be performed at the same time.
Your doctor may use laparoscopy to check for blockages, growth, or signs of endometriosis around the uterus and fallopian tubes. This procedure involves the insertion of a small, surgical scope into the abdomen under general anesthesia.
For this special ultrasound exam, saline will be used to inflate your uterine cavity, giving your doctor a more detailed view of the uterus than traditional ultrasound can.
Depending on your experience, you may need to repeat tests or procedures several times throughout your treatment journey.
Your doctor will ask about your medical history, including information on:
Similar to females, you’ll be asked to share details about your lifestyle, including your diet, exercise routine, work environment, and current sexual practices. Your doctor will also ask if you smoke, drink, or use drugs.
In order to father a child, a male must have the right balance of hormones for sperm to develop, sperm of healthy quality and quantity, a functioning reproductive tract, and unblocked sperm ducts. Conducting examinations and tests will help your doctor diagnose and treat male factor infertility if it exists.
Expect your doctor to conduct the following:
Your doctor will usually examine your penis, testicles, and prostate gland (via your rectum) to check for any abnormalities. Your scrotum will be examined for varicose veins, which can affect fertility. Your doctor will also confirm your sperm ducts (epididymis and vas deferens) are present and intact to ensure a healthy, functioning reproductive tract.
You’ll be tested for hepatitis B and C, and human immunodeficiency virus (HIV). Depending on your heritage, you may also be tested for diseases or disorders that are more common among certain ethnic groups, such as sickle cell anemia or cystic fibrosis.
These may be done to test certain hormones, such as FSH, testosterone, and prolactin. Fertility may be affected if levels are outside the normal range.
You may be asked to provide a semen sample. This is done by masturbating either at home or at your clinic. The quality and volume of semen will be tested, including sperm count, concentration, movement (motility), size, and shape (morphology).
Your doctor may perform this test if there are no sperm present in your semen sample. After being given an anesthetic, your doctor will remove a small sample of tissue from one of your testicles, which will be tested to see if it contains any sperm that can be used in fertility treatment.
After reviewing results from this initial visit, your reproductive endocrinologist (RE), andrologist, or urologist may want to proceed with future testing. Advanced tests and procedures for men include:
This scan is used to identify blockages or varicose veins around your testicles or sperm ducts that could be causing infertility. Your doctor will pass a small device back and forth over your scrotum to pick up soundwaves, which are converted into an image.
Your doctor will use this scan for thorough overview of your prostate, the semen-producing glands (called seminal vesicles), and the duct that carries sperm from your testicles to your urethra (called the vas deferens). A thin probe will be inserted into your rectum while you lie on your side. Most men find this uncomfortable, but painless.
If your initial semen analysis results are abnormal, you may need to provide another semen sample. Your doctor will check that enough sperm are alive, and that there are no antibodies or infections in your semen.
Your doctor may order additional sperm analysis if preliminary examination indicates there may be a problem. These tests provide more details on the mobility of your sperm.
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