With infertility testing, not knowing what to anticipate can be the most difficult part of all. In general the tests are fairly predictable, so it’s easy to get a good idea of what to expect. Be ready for an onslaught of personal questions at your intial consultation. You’ll almost certainly need to have a physical too, and then if the doctor can’t find anything obviously wrong there you might have to get started with the next stage of testing.
· Blood tests and Urine tests – These will check LH (luteinizing hormone) and FSH (follicle stimulating hormone) during your cycle to confirm if you’re ovulating. These could also be used to check for thyroid problems or to check if you have an excess of prolactin – the hormone that stimulates your body to make milk and not ovulate – not useful if you don’t have a baby yet! You’ll also be tested for STDs.
· Postcoital test – Yup, you go for a test a short while after doing the baby dance, usually on the day prior to ovulation. The aim is to verify that the sperm actually made it to the cervix and that they are still swimming vigorously, although the test isn’t extremely reliable, which is not necessarily a distressing thing, or else they could do it more regularly and that’s no fun!
· Pap smear – The doc takes a sample of the tissue at the opening of the cervix (the os) to check for cervical cancer.
· Pelvic Examination – Also known as the bimanual examination – two fingers in, two fingers out. A speculum (used for peeking inside) might also be used and swabs could be taken.
· Pelvic Ultrasound – This test uses sound waves to check for any structural abnormalities.
· Laparoscopy – The doctor makes a little incision on the abdomen to make way for a tiny camera to check for scars or cysts or other visible problems – it may sound rather sci-fi, but you’ll probably be under anesthetic so you won’t even realize what’s happening.
· Sonohysterogram – A salt-water solution is injected into the uterine cavity to look via ultrasound for any irregularities.
· Hysterosalpingogram – Fallopian tube obstructions can be checked (and sometimes even unblocked) by injecting fluid that shows up on X-ray into the uterus.
· Endometrial Biopsy – A healthy uterus is essential for getting pregnant so these tests can monitor the condition of the endometrium (the lining of the uterus).
· Antibody test – A test to see if your body is making anti-sperm antibodies.
· Hysteroscopy – A tiny camera is inserted through the vagina to screen for any visible abnormalities.
For the men:
· Blood tests – To check LH, FSH and testosterone concentrations to see if the man has a pituitary gland problem, and also to check for STDs.
· Analysis of Semen – That’s right, you’ll have to do the deed in a cup and have it tested pretty soon afterwards before all the sperm die of old age. Many vigorous well-built sperm are ideal.
· Testicular Examination – Normally this test forms part of your general physical and the doctor will check for enlarged veins on the scrotum that overheat and kill spermies.
· Antibody test – To see that your immune system isn’t slaughtering the sperm without even giving them a chance to even make it out the door.
· Ultrasound – To check if there are any problems with the testicles.
· Testicular Biopsy – The doctor will take a swab of tissue from the testicles to check if they have sperm, especially if your semen doesn’t have any sperm in it.
Genetic testing may help to find any genetic conditions that make infertility more likely. The easiest tests are performed first and if no problem is found then extra testing may be needed. This is good news because the more complicated testing procedures are fairly expensive! A few of the tests may be uncomfortable, and the embarrassment of having someone pushing and prodding around ‘down there’ seems to make any discomfort worse!
All of those tests will really help you discover what is causing your infertility. When you understand what the problem is then you can figure out what to do about it. Then again, after all those tests you might still find that you’re infertile and without any clue as to why, or you could find that your condition isn’t curable and that can be really hard. Either way, it is a helpful to have therapy for both of you all through the process and your infertility clinic will probably have specialized support available.