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Fertility tests are done to determine the cause of infertility and whether the problem lies with the male or female partner or both. After proper history taking and physical examination, the following tests and procedures are advised :

• complete blood count
• grouping and Rhesus factor
• German measles (rubella)
• hepatitis B
• HIV
• syphilis

Based on the results of these tests, further special testing and other investigative procedures may be necessary for each partner. The findings will determine the appropriate infertility treatment that should be considered for the individual or couple.

Infertility Tests for Men

• Semen analysis is when a specimen of semen is collected and analyzed in the laboratory, particularly for sperm count, morphology (shape and structure), and motility (movement) of the sperm.
• Hormone testing is a blood test to evaluate the level of testosterone and other male hormones.

Infertility Tests for Women

Fertility Blood Tests

Blood tests are done to evaluate the levels of various hormones affecting the reproductive process. Interpretation of the results depend on the  day of the menstrual cycle when the blood sample was taken. Some of hormones tested may include :

• Follicle stimulating hormone (FSH) which is secreted by the pituitary gland and its level increases as a woman approaches menopause and the ovaries show signs of aging.
• Luteinizing hormone (LH) controls egg development, but consistently high levels of this hormone hinders this process.

The two tests above are done on the third day of the menstrual cycle. A second hormone evaluation may be done one or two days before ovulation, when FSH and LH levels are measured again. High levels of FSH and LH may be a sign of ovarian problems, while low levels may indicate a pituitary or hypothalamic disorders.

Other tests may monitor or test the following :

• Estradiol level in the blood often detects a decrease in egg quantity and quality even though the day 3 FSH level is normal.

• Clomiphene challenge test can detect poor ovarian reserve even when the day 3 FSH level is normal. This test is done by noting the day 3 FSH and estradiol levels, taking 2 tablets of clomiphene (100 mg) on days 5 to 9 of the menstrual cycle, and repeating FSH level on day 10. The result is taken as normal if FSH and estradiol levels are low on day 3 and FSH level is also low on day 10.

• Prolactin levels if high inhibits release of FSH and LH, preventing ovulation.

• Thyroid function tests to exclude thyroid disease as the cause of infertility.

• Progesterone test is done around day 21 of the menstrual cycle and a high level of progesterone confirms ovulation.

Fertility Procedures

Other diagnostic procedures may also be conducted to verify other factors that may contribute to infertility in women.

• Pelvic ultrasound is done to determine size and structure of the uterus and ovaries and detect conditions such as uterine fibroid.

• Hysterosalpingogram is an x-ray test to see the inside of the tubes and uterus to detect tubal blockage or any other abnormality in the tubes or uterus.

• Laparoscopy is when a tiny incision near the umbilicus allows a thin lighted tube to be put inside the abdomen to view the woman’s pelvic organs. Possible causes of infertility such as adhesions, cysts, fibroid, and endometriosis can be diagnosed.

• Endometrial biopsy is when a small sample of uterine tissue is used to check if normal changes are taking place in the endometrium during the menstrual cycle.

• Karyotype or Genetic tests.  Karyotyping may be necessary to look for problems in the genetic material (chromosomes) of the cells and genetic tests may help to find the cause of infertility or frequent abortions.