If you’re trying to get pregnant, one of the most important things to do is learn how to determine when you’re ovulating, when is the best time for sexual intercourse, and the steps you can take to increase your chances of a successful outcome. We also encourage every woman to know early pregnancy signs and symptoms and how to get accurate results from a home pregnancy test. If things go wrong, (miscarriage or ectopic pregnancy) you can try again.

Common Fertility Problems

Sometimes infertility is the result of a specific health disorder. This section addresses both common and unusual problems like thyroid complications, low sperm count, erectile dysfunction, abnormalities after age 30 and other issues that can affect female and male fertility. There’s also a discussion of age and pregnancy. With more women waiting longer to have their first child, understanding how age affects female fertility is important.

When You Need Some Help

Ovulation evaluation may be broken down into types:

  • Ovulation testing— to confirm if ovulation is occurring by looking through your temperature charts, using ovulation predictor kits and blood tests and ultrasound.
  • Ovarian function tests–These tests are looking to see how the hormones are functioning and working during your ovulation cycle. Tests include the Day 3 FSH (measuring follicle stimulating hormone), Day 3 Estradiol (measuring estrogen), ultrasound (to confirm ovulation occurred) and blood tests to determine the levels of inhibin B.
  • Luteal Phase testing– Testing will evaluate progesterone levels, more extensive hormone testing, and possibly an endometrial biopsy ( see below for more info on this procedure.)
  • Hormone tests: Most all of this testing will revolve around through hormone tests.

These hormone tests include the following:

  • Luteinizing Hormone
  • Follicle Stimulating Hormone
  • Estradiol
  • Progesterone
  • Prolactin
  • Free T3
  • Total Testosterone
  • Free Testosterone
  • DHEAS
  • Androstenedione

The following tests are also commonly used in the first evaluated cycle:

  • Cervical mucus tests: This involves a post-coital test (PCT) which determines if the sperm is able to penetrate and survive in the cervical mucus. It also involves a bacterial screening.
  • Ultrasound tests: This is used to assess the thickness of the lining of the uterus (endometrium), to monitor follicle development and to check the condition of the uterus and ovaries. An ultrasound may be conducted two to three days later to confirm that an egg has been released.

If both the semen analysis and the above testing return normal results, there is also additional testing that your fertility specialists may recommend.

These tests include any of the following:

  • Hysterosalpingogram (HSG): This is an x-ray of your uterus and fallopian tubes. A dye is injected through the cervix into the uterus and fallopian tubes. The dye enables the radiologist to see if there is a blockage or some other problem.
  • Hysteroscopy: This is a procedure that may be used if the HSG indicates the possible presence of abnormalities. The hysteroscope is inserted through the cervix into the uterus, which allows your fertility specialist to see any abnormalities, growths, or scarring in the uterus.  The hysteroscope allows the physician to take pictures which can be used for future reference.
  • Laparoscopy: This is a procedure done under general anesthesia, that involves the use of a narrow fiber optic telescope under. The laparoscope is inserted into a woman’s abdomen to provide a view of the uterus, fallopian tubes, and ovaries. If any abnormalities such as endometriosis, scar tissue or other adhesions are found, they can be removed by a laser. It is important to confirm that you are not pregnant before this test is performed.
  • Endometrial biopsy: This is a procedure that involves scraping a small amount of tissue from the endometrium just prior to menstruation.  This procedure is performed to determine if the lining is thick enough for a fertilized egg to implant in and grow. It is important to confirm that you are not pregnant before this test is performed.

These tests are not mandatory and your fertility specialists will know which tests to recommend in your situation.

Finally…

Some couples want to explore more traditional or over the counter efforts before exploring infertility procedures. We are here to help! Contact us with any questions or to schedule an appointment.
(Some information provided by the American Pregnancy Association).