The assessment of female infertility

March 2017

If you have not been able to become pregnant within one year, your GP may initiate some investigations for you and your partner.

Below are some examples of tests for women that may be arranged by your GP or a specialist.
  • Gynaecological examination: to detect possible anatomical anomalies or an infection.
  • Temperature: to determine if ovulation has taken place.
  • Blood tests: to obtain hormonal levels during the cycle and at ovulation
  • A pelvic ultrasound scan and hysterosalpingography (HSG): to identify anomalies of the female anatomy.

Temperature


Temperature monitoring is probably the simplest examination to carry out.

It can give information about the length of your cycle and determine when ovulation occurs.

Temperature correlates to the level of progesterone in your blood and should be measured first thing in the morning for a few cycles. Ovulation occurs a day before the temperature starts rising.

There are 5 most fertile days in your cycle, starting 4 days before ovulation.

Gynaecological examination


Your GP will examine you internally and may perform swabs and a cervical smear.

This is to detect possible anatomical anomalies or an infection that may prevent pregnancy.

Hormonal blood tests


Hormonal blood tests are useful to screen for any abnormalities and establish where you are in your cycle.

Your doctor will check your LH and FSH levels which are released by your brain to send signals to your ovaries.

Your oestrogen and testosterone levels will be screened for any abnormalities.

Progesterone levels are measured to check for ovulation.

Other conditions such as hypothyroidism which can cause infertility problems will also be excluded by blood tests.


Hysterosalpingography (HSG)


Hysterosalpingography is performed by specialists to assess the patency of your uterus and fallopian tubes by injecting dye.

It gives additional information to an ultrasound.

Laparoscopy


A diagnostic laparoscopy may also be necessary.

This involves an operation where a camera is placed inside your abdomen so that the specialist surgeon can directly visualise the outside of your uterus, ovaries and fallopian tubes.

Endometrial biopsy


A sample of the lining of your endometrium is taken so that it can be examined under a microscope to check for any abnormalities.

Related


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