Female Infertility & Testing

What Is Female Infertility?

Female infertility refers to the inability of a woman to conceive or carry a pregnancy to full term despite regular unprotected intercourse. It can result from various factors such as hormonal imbalances, ovulatory disorders, reproductive system abnormalities, or age-related issues. Treatment options vary depending on the underlying cause, which can be identified through various types of fertility evaluations and diagnostic procedures.

Infertility Testing for Female Infertility

Infertility tests include lab tests (e.g., testing blood for hormone levels), imaging tests, and minimally invasive diagnostic procedures to examine reproductive organ function. These may include:

• Medical History and Physical Examination: The fertility care team gathers information about your menstrual cycle regularity, sexual history, and any previous pregnancies or miscarriages, as well as your medical history. A complete physical examination is often performed to evaluate your overall level of health.

• Ovulation Assessment: Evaluating ovulation involves monitoring your menstrual cycle and assessing for signs of regular ovulation, such as a slight increase in basal body temperature, or the results from ovulation prediction kits. For the most part, if a woman is having regular menstrual cycles, she is very likely ovulating. 

• Hormonal Testing: There are several hormones that influence reproductive function, so assessing hormonal levels via blood tests often provides valuable insights into fertility issues. There are several different tests you may undergo, including those that measure the level of hormones that influence conception, such as follicle-stimulating hormones (FSH), luteinizing hormones (LH), estradiol, thyroid-stimulating hormones (TSH), prolactin, and anti-Müllerian hormones (AMH).

• Anti-Mullerian hormone (AMH): AMH testing is one of the more common hormone tests used to evaluate female fertility. As AMH is produced in the ovaries, a normal AMH balance typically indicates normal ovarian reserve, while low AMH levels can be a sign of diminished ovarian reserve or potentially premature menopause. Measuring AMH levels is also crucial in determining how a patient may respond to ovarian stimulation medications, such as those used in in vitro fertilization (IVF).

• Ovarian Reserve Testing: This involves evaluating the quantity of eggs in your ovaries. Tests such as the antral follicle count (AFC) are conducted using ultrasound, alongside AMH and hormone testing.

• Hysterosalpingography (HSG): An HSG test is performed by injecting a contrast dye into the fallopian tubes and uterus, and then taking X-rays to evaluate whether there are any blockages or abnormalities.

• Transvaginal Ultrasound Testing: Using a probe inserted through the vagina, this type of ultrasound examines the ovaries and uterus to detect any cysts, fibroids, or structural abnormalities.

• Laparoscopy: Laparoscopy is a minimally invasive surgical procedure that involves the insertion of a tube with a camera through a small incision; this test is often used to diagnose endometriosis or scar tissue in the pelvic organs.

• Genetic Testing: Infertility can sometimes be caused by hereditary conditions or chromosomal abnormalities detected through genetic testing. Genetic testing can be immensely helpful in several scenarios, including for patients who have experienced recurrent miscarriages.

• Saline Infusion Sonogram (SIS): A SIS test is performed to test for uterine deformities (e.g., polyps, fibroids or scar tissue) that could interfere with getting pregnant. The procedure involves a catheter that is inserted into the cervix to examine whether polyps, myomas, or other anomalies are present inside the uterus. Saline is injected into the uterine cavity while a transvaginal ultrasound is performed to view ultrasound images, in real-time, of the uterus. Your doctor may also test the patency of your fallopian tubes with the SIS test.