Female infertility testing

For women unable to conceive within 12 months of regular, unprotected intercourse below the age of 35, or six months for women older than age 35, testing for infertility can help couples or individuals identify relevant factors causing infertility.

Any evaluation for infertility should include male and female partners, and start with the least invasive (and least expensive methods) that can detect common causes of infertility. 

There are several ways to see if a woman is ovulating or producing an egg. These include: 

Historical analysis

A close examination of menstrual history can be one of the best indicators of ovulation. A history of regular, cyclic and predictable menstruation indicates ovulation and is present in almost 98% of women. Therefore, in reality, there is no need for further testing to document ovulation in regularly cycling women. 

Hormone testing

Fertility clinics can check blood levels for progesterone hormones in the second half of the cycle. 

Ovulation predictor kits

Available commercially, these kits check the urine for Luteinizing Hormone rises that occur 18-24 hours before ovulation. These tests come with clear instructions that will help you predict the day you’ll ovulate. Sometimes, however, these tests can be false and lead to confusion. 

Basal body temperature

Used extensively in the past but frustrating to the patient, the basal temperature in females undergoes a sustained rise of 0.3 to 0.5 degrees Fahrenheit during the second half of the luteal phase, right before ovulation. This shift in temperature is due to the secretion of Progesterone by the Corpus Luteum. The woman must take her oral or rectal temperature for five minutes with a basal thermometer every morning before any physical activity. 

Unfortunately, there may be instances when ovulatory women exhibit an abnormal basal body temperature chart. 

Cervical mucus

When examining cervical mucus, the buildup should become clear, thin and stretchable around the time of ovulation to help sperm travel through the canal and reach an egg. 

The postcoiatal test should be performed around the time of ovulation a few hours after intercourse. Then, your doctor takes a sample of cervical mucus and checks for the presence of motile sperm, clarity and thickness. 

Endometrial biopsy

This test involves taking a tissue sample from the lining of the uterus, called the endometrium. By doing this, doctors can evaluate the adequacy of the uterine lining when supporting a pregnancy and can determine if ovulation occurs. Some women who suffer from Luteal Phase Defect can have very short cycles. 

Ultrasonography

Recent advances in ultrasound technology have revolutionized the field of reproductive medicine. Ultrasounds can diagnose a multitude of problems in the patient, such as identifying cysts, fibroids, polyps, swollen or blocked tubes, and monitor follicular development prior to ovulation or during fertility treatment with fertility hormones. 

This test is most effective through a vaginal ultrasound, where an ultrasound probe is inserted to visualize the pelvic organs.