Female Infertility - Diagnosis

Diagnosis

Diagnosis of infertility begins with a medical history and physical exam. The healthcare provider may order tests, including the following:

• Lab tests
  • hormone testing, to measure levels of female hormones at certain times during a menstrual cycle
  • day 2 or 3 measure of FSH and estrogen, to assess ovarian reserve
  • measurements of thyroid function (a thyroid stimulating hormone (TSH) level of between 1 and 2 is considered optimal for conception)
  • measurement of progesterone in the second half of the cycle to help confirm ovulation

• Examination and imaging
  • an endometrial biopsy, to verify ovulation and inspect the lining of the uterus
  • laparoscopy, which allows the provider to inspect the pelvic organs
  • fertiloscopy, a relatively new surgical technique used for early diagnosis (and immediate treatment)
  • Pap smear, to check for signs of infection
  • pelvic exam, to look for abnormalities or infection
  • a postcoital test, which is done soon after intercourse to check for problems with sperm surviving in cervical mucous (not commonly used now because of test unreliability)
  • special X-ray tests

There are genetic testing techniques under development to detect any mutation in genes associated with female infertility.

Diagnosis and treatment of infertility should be made by physicians who are fellowship trained as reproductive endocrinologists. Reproductive Endocrinologists are usually Obstetrician-Gynecologists with advanced training in Reproductive Endocrinology & Infertility (in North America). These highly educated professionals and qualified physicians treat Reproductive Disorders affecting not only women but also men, children, and teens.

Prospective patients should note that reproductive endocrinology & infertility medical practices do not see women for general maternity care. The practice is primarily focused on helping their patients to conceive and to correct any issues related to recurring pregnancy loss.