Infertility tests are
done to help find out why a woman cannot become pregnant. The tests help find
whether the problem is with the man, the woman, or both. Tests usually include
a physical exam, semen analysis, blood tests, and special procedures.
Should I be tested?
Before you have infertility
tests, try fertility awareness methods to find the best time to
become pregnant. A woman is most fertile during ovulation and 1 to 2 days before ovulation. Some
couples find that they have been missing the most fertile days when trying to
become pregnant. A woman should keep a record of her menstrual cycle and when
she ovulates. This record will help your doctor if you decide to have
Some tests, such as
a semen analysis, physical exam, and blood tests, do not cause pain. But
some procedures, such as an endometrial biopsy, a laparoscopy, or a hysterosalpingogram, may cause some pain.
Do the tests cost a lot?
Infertility tests can
cost a lot and cause stress. You and your partner will need to keep track of
the frequency of sexual intercourse and talk about this with your
Before you have infertility tests, talk with your partner
about how much testing you want to do. Sometimes you may not find out what
causes infertility even after many tests. So it is important to know how many
tests you want to try.
What are the risks of infertility tests?
tests, such as semen analysis, blood tests, or an ultrasound, do not usually cause any problems. Other
tests that are medical procedures, such as hysteroscopy or laparoscopy, have a higher chance of
problems after the test.
Infertility tests may find what is causing the problem and you can
sometimes be treated during the tests. For example, a blocked fallopian tube may be opened during a
Sometimes tests cannot find the cause of
infertility. And not all infertility problems can be treated. Infertility in men
is often less successfully treated than infertility in women. But you may still
be able to become pregnant using assisted reproductive technology, which can treat male
or female problems.
What tests are done first?
Tests to find the cause of infertility
Both partners: Medical history
Your doctor will ask questions about your
sex life, your birth control methods, any sexually transmitted infections (STIs), medicine use, and
the use of caffeine, tobacco, alcohol, or illegal drugs. Your menstrual cycle
and exercise patterns will be checked. If STIs are suspected, more tests may be
Both partners: Physical
A complete physical exam of both you
and your partner is done to check your health.
A woman’s physical exam usually
includes a pelvic examination and Pap test.
A man’s physical exam usually includes a
testicular examination. Not all fertility doctors will
do a physical examination of the man. If there are problems with the semen, the
doctor may refer the male partner to a urologist.
The anti-mullerian hormone test is a blood test that is sometimes used to check a woman’s egg supply (ovarian reserve). It may be used for women who are considering IVF. Anti-mullerian levels go down as a woman’s egg supply decreases, which usually happens with age.
In some cases, follicle-stimulating hormone (FSH) may be used to
check a woman’s egg supply (ovarian reserve). FSH testing may also be
used for men with a very low number of sperm to try to find out the source of
A testosterone test may be used to see whether a problem
with the testicles or pituitary gland is preventing a man from being able to
father a child. A low amount of testosterone can lead to low sperm counts.
Tests for sexually transmitted infections (STIs) may be done. These may include urine samples or
samples from the cervix or urethra.
Male partner: Semen analysis
A semen analysis checks the number of sperm
(sperm count), the number of sperm that look normal, the number of sperm that
can move normally, the number of white blood cells in the semen, and how much semen is
the first tests do not find a cause for infertility, the woman may have one or
more of the following tests.
Tests for women to find the cause of infertility
A pelvic ultrasound looks at the size and
structure of the uterus and both ovaries. It can check the condition and size of
the ovaries during treatment for infertility. It can also be used to check a woman’s egg supply (ovarian reserve). This is done by counting the number of follicles in both ovaries during a certain phase of the menstrual cycle (antral follicle count).
A hysterosalpingogram is an X-ray test that looks at the inside of the uterus and
the fallopian tubes. The pictures can show a blockage of the fallopian tubes
that would prevent an egg from reaching the uterus or prevent sperm from moving
into a fallopian tube to join (fertilize) an egg. This test may also see
problems on the inside of the uterus that might prevent a fertilized egg from
attaching (implanting) to it.
Laparoscopy is a procedure to look at a
woman’s pelvic organs (uterus, fallopian tubes, and ovaries) using a thin,
lighted scope that is put through a small cut (incision) in the belly. This
procedure is used to find cysts, scar tissue (adhesions), fibroids, and infections that can affect fertility.
Laparoscopy can also be used to treat conditions, such as endometriosis. Laparoscopy is usually done with general anesthesia.
hysterosalpingogram, laparoscopy, or endometrial biopsy does not find a reason
for your infertility, or if your infertility treatment has been unsuccessful,
one or more of the following tests are sometimes used.
Other tests to find the cause of infertility
Both partners: Antibody blood
Antibody blood tests may be done to find
antisperm antibodies in blood, semen, or vaginal fluids. Doctors question the
value of antibody tests for finding the cause of infertility.
Hysteroscopy is a procedure that looks at
the lining of the uterus using a thin, lighted scope that is put through the
vagina and cervix into the uterus. Hysteroscopy is used to find problems in the
uterine lining. Sometimes your doctor can use small tools during the procedure
to take out growths or take samples of tissue (biopsy) or open a blocked
Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby.
Practice Committee of American Society for Reproductive Medicine (2012). Diagnostic evaluation of the infertile female: An American Society for Reproductive Medicine practice committee opinion. Fertility and Sterility, 98(2): 302-307.
Practice Committee of American Society for Reproductive Medicine (2012). Diagnostic evaluation of the infertile male: An American Society for Reproductive Medicine practice committee opinion. Fertility and Sterility, 98(2): 294-301.
ByHealthwise Staff Primary Medical ReviewerSarah Marshall, MD – Family Medicine Adam Husney, MD – Family Medicine Specialist Medical ReviewerFemi Olatunbosun, MB, FRCSC – Obstetrics and Gynecology