If you are infertile, your doctor will go over your health history, medications, sexual history, and your sex habits, like how often you have sex. Tests depends on the condition the doctor suspects the patient has.
In about 80% of couples, the cause of infertility is either an ovulation problem, blockage of the fallopian tubes, or a sperm problem. In 5%-15% of couples, all tests are normal, and the cause is not known.
Tests for men
You may have a general physical exam. This includes an examination of your genitals. Specific fertility tests may include:
- Semen analysis. Semen is generally obtained by masturbating or by interrupting intercourse and ejaculating your semen into a clean container. A laboratory analyzes your semen specimen.
- Hormone testing. Determine the level of testosterone and other male hormones.
- Transrectal and scrotal ultrasound.
- Genetic testing. Genetic testing may be done to determine whether there’s a genetic defect causing infertility.
- Testicular biopsy. This test involves removing samples from the testicle with a needle. The results of the testicular biopsy will tell if sperm production is normal.
- Other testing. In some cases, other blood or semen tests may be recommended to try to determine why the sperm may not be able to effectively fertilize the egg.
Tests for women
You may have a general physical exam. This includes a regular gynecological exam. Specific fertility tests may include:
- Ovulation testing. A blood test is performed to measure hormone levels to determine whether you’re ovulating, if you have not had positive home ovulation tests.
- Hysterosalpingography. Hysterosalpingography evaluates the condition of your uterus and fallopian tubes.
- Ovarian reserve testing. This testing helps determine the quality and quantity of the eggs available for ovulation.
- Other hormone testing. Other hormone tests check levels of ovulatory hormones, as well as thyroid and pituitary hormones that control reproductive processes.
- Imaging tests. Pelvic ultrasound looks for uterine or fallopian tube disease. Sometimes a hysterosonography is used to see details inside the uterus that are not seen on a regular ultrasound.
In men, fertility is treated with:
- Surgery, if the cause is a varicoele (widening of the veins in the scrotum) or a blockage in the vas deferens, tubes that carry sperm.
- Antibiotics to treat infections in the reproductive organs.
- Medications and counseling to treat problems with erections or ejaculation.
- Hormone treatments if the problem is a low or high level of certain hormones.
In women, infertility is treated with:
- Fertility drugs and hormones to help the woman ovulate or restore levels of hormones
- Surgery to remove tissue that is blocking fertility (such as endometriosis) or to open blocked fallopian tubes
Infertility in men and woman can also be treated with assisted reproductive technology, or ART. There are several types of ART:
- IUI (intrauterine insemination): Sperm is collected and the placed directly inside the woman’s uterus while she is ovulating.
- IVF (in vitro fertilization): The sperm and egg are collected and brought together in a lab. The fertilized egg grows for 3 to 5 days days. Then the embryo is placed in the woman’s uterus.
- GIFT (gamete intrafallopian transfer) and ZIFT (zygote intrafallopian transfer): The sperm and egg are collected, brought together in a lab, and quickly placed in a fallopian tube. With GIFT, the sperm and eggs are placed into the fallopian tube. With ZIFT, a fertilized egg is placed into the tube at 24 hours.