When It's Time for Fertility Testing

Seeking Help

After six months of well-timed sexual intercourse, about 81 percent of couples will become pregnant. However, for the remaining 19 percent that have not gotten pregnant, about 50 percent will receive a preliminary diagnosis of infertility and may need to go through assisted reproductive technology (see What Is Assisted Reproductive Technology (ART)?). The other 50 percent will go on to conceive naturally. Of the cases of infertility, about 40 percent of them are due to female problems, 40 percent are due to male problems, and the other 20 percent are classified as unexplained infertility.
After six months of unsuccessful trying, you may be ready for some preliminary testing. This can be a very emotional time, as month after month your hopes of seeing that "+" sign on the pregnancy test leaves you with more questions and more disappointment. Having your healthcare provider run some preliminary tests after six months may help to alleviate some of your worries -- either to help give you peace of mind to keep trying, or to find out that maybe something else is going on and requires treatment.
If these initial tests come back abnormal, you can begin looking at ways to treat the issues right away rather than waiting another six months of trying naturally.

What Are the Initial Fertility Tests for Women?

Making the decision to seek help from your healthcare provider can be a difficult step for a woman and her partner. For some, it can be embarrassing, and you may be worried about what kind of tests you will have to go through to figure out if anything is wrong.
Most healthcare providers have their own order for scheduling tests. In many cases, the first step you will have to go through is giving your healthcare provider a detailed medical history. Although you may be anxious to get the ball rolling, if your healthcare provider initially recommends in vitro or another expensive fertility treatment, you may want to get a second opinion. In most cases, healthcare providers will start with the least invasive, least expensive, and least risky options before moving on to the more complex procedures.
Some of the topics you will cover while discussing your medical history include:
  • Menstrual history
  • Pregnancy history
  • Birth control history
  • Current sexual patterns
  • History of any sexually transmitted diseases (STDs)
  • Surgical history
  • Medications
  • Other significant health problems
  • Lifestyle and work environment.
After a thorough history has been covered, the next step is a physical examination. This may include a pelvic examination and possibly an ultrasound. Either an abdominal or vaginal ultrasound can be used to visualize the uterus and ovaries, although vaginal ultrasounds are more sensitive. These tests are done to help rule out several possible fertility problems. The ultrasounds may be used throughout your fertility testing to monitor the growth of follicles on the ovary during a cycle, or to detect fibroids or ovarian cysts.
Other things your healthcare provider will be looking for during the physical examination include:
  • Feeling your thyroid for any abnormalities
  • Checking to see if you have any unusual or excessive hair patterns on your face and body indicating an excess of male hormones, which can affect fertility
  • A breast examination
  • Pelvic examination to inspect the cervix.
Last reviewed by: Arthur Schoenstadt, MD
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