The World Health Organization defines infertility as “the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.” But that just describes the effect. How can you find out what’s causing it? Your doctor may suggest various tests for infertility to get the answer.

Tests for Women

Many tests for infertility measure levels of various hormones important to fertility, including luteinizing hormone (LH), follicle stimulating hormone (FSH), and progesterone. While there are at-home infertility tests that measure LH for tracking ovulation, you will need to give a blood or urine sample for proper laboratory testing when trying to measure hormone levels and their impact on infertility.

Other tests for infertility use different types of imaging to identify the condition of the ovaries, uterus, and other organs. Sonohysterograms and pelvic ultrasounds use sound waves to create an image of the reproductive system. These can reveal masses or scarring in the uterus that can affect fertility.

A hysterosalpingogram is an X-ray test using contrast dye injected into the uterus and Fallopian tubes. It can show problems like blockages in the Fallopian tubes or abnormal structure of the uterus.

Laparoscopy uses a flexible tube to directly view the inside of the body. It is often used to detect cysts, adhesions, and even infection. It can also be used to conduct a biopsy or to treat endometriosis and ectopic pregnancy.

Tests for Men

The first test of male fertility is generally a semen analysis. A sample of semen is examined for sperm count as well as sperm motility and morphology — the movement and shape of the sperm. These metrics are the most common factors involved in male infertility.

Hormone tests for men generally check on levels of testosterone. Testosterone is closely connected to sperm production and controls production of LH and FSH in a predictable cycle. In most cases, this is the only hormone test performed on men, but in cases of extremely low sperm count, tests for LH and FSH may also be necessary.

A urine test may be conducted immediately after ejaculation. If sperm are found in the urine, it can mean that semen is flowing up into the bladder rather than out through the urethra — a condition known as retrograde ejaculation. This can be the result of surgery or even medications for conditions including high blood pressure or depression.

An ultrasound test can detect abnormalities in the testicles. Masses, swelling, twisting, and other disturbances of the testicles can all impact sperm production and lower fertility. An ultrasound can also be used to guide a testicular biopsy.

In the rare case when semen tests show no sperm but hormone tests come back in the normal range, you may need a testicular biopsy. A small tissue sample from the testicle is sent to a pathologist for examination. If the sample looks normal, it could indicate a blockage in the vas deferens, the tubes that lead from the testicles to the urethra.

As you can see, there are many ways to discover the cause of fertility problems. Consult with your doctor about which tests for infertility may be right for you. If you want more information about improving fertility or tips for conceiving, follow us on Facebook and Twitter, or sign up for our newsletter below.