Before infertility testing, your doctor or clinic works to understand your sexual habits and may make recommendations to improve your chances of getting pregnant. In some infertile couples, no specific cause is found (unexplained infertility).
Infertility evaluation can be expensive, and sometimes involves uncomfortable procedures. Some medical plans may not cover the cost of fertility treatment. Finally, there’s no guarantee — even after all the testing and counseling — that you’ll get pregnant.
Tests for men
Male fertility requires that the testicles produce enough healthy sperm, and that the sperm is ejaculated effectively into the vagina and travels to the egg. Tests for male infertility attempt to determine whether any of these processes are impaired.
You may have a general physical exam, including examination of your genitals. Specific fertility tests may include:
- Semen analysis. Your doctor may ask for one or more semen specimens. Semen is generally obtained by masturbating or by interrupting intercourse and ejaculating your semen into a clean container. A lab analyzes your semen specimen. In some cases, urine may be tested for the presence of sperm.
- Hormone testing. You may have a blood test to determine your level of testosterone and other male hormones.
- Genetic testing. Genetic testing may be done to determine whether there’s a genetic defect causing infertility.
- Testicular biopsy. In select cases, a testicular biopsy may be performed to identify abnormalities contributing to infertility or to retrieve sperm for assisted reproductive techniques, such as IVF.
- Imaging. In certain situations, imaging studies such as a brain MRI, transrectal or scrotal ultrasound, or a test of the vas deferens (vasography) may be performed.
- Other specialty testing. In rare cases, other tests to evaluate the quality of the sperm may be performed, such as evaluating a semen specimen for DNA abnormalities.
Tests for women
Fertility for women relies on the ovaries releasing healthy eggs. The reproductive tract must allow an egg to pass into the fallopian tubes and join with sperm for fertilization. The fertilized egg must travel to the uterus and implant in the lining. Tests for female infertility try to find out if any of these processes are impaired.
You may have a general physical exam, including a regular gynecological exam. Specific fertility tests may include:
- Ovulation testing. A blood test measures hormone levels to determine whether you’re ovulating.
- Hysterosalpingography. Hysterosalpingography (his-tur-o-sal-ping-GOG-ruh-fee) evaluates the condition of your uterus and fallopian tubes and looks for blockages or other problems. X-ray contrast is injected into your uterus, and an X-ray is taken to determine if the cavity is normal and to see if the fluid spills out of your fallopian tubes.
- Ovarian reserve testing. This testing helps determine the quantity of the eggs available for ovulation. This approach often begins with hormone testing early in the menstrual cycle.
- Other hormone testing. Other hormone tests check levels of ovulatory hormones, as well as pituitary hormones that control reproductive processes.
- Imaging tests. Pelvic ultrasound looks for uterine or ovarian disease. Sometimes a sonohysterogram, also called a saline infusion sonogram, is used to see details inside the uterus that are not seen on a regular ultrasound.
Depending on your situation, rarely your testing may include:
- Hysteroscopy. Depending on your symptoms, your doctor may request a hysteroscopy to look for uterine disease. During the procedure, your doctor inserts a thin, lighted device through your cervix into your uterus to view any potential abnormalities.
- Laparoscopy. This minimally invasive surgery involves making a small incision beneath your navel and inserting a thin viewing device to examine your fallopian tubes, ovaries and uterus. A laparoscopy may identify endometriosis, scarring, blockages or irregularities of the fallopian tubes, and problems with the ovaries and uterus.
Not everyone needs to have all, or even many, of these tests before the cause of infertility is found. You and your doctor will decide which tests you will have and when.
Thyroid-stimulating Hormone (TSH) Blood Test
The Thyroid-stimulating Hormone (TSH) Blood Test checks thyroid gland function.
Estradiol (E2) Blood Test
The Estradiol (E2) Blood Test measures estradiol levels, one of the primary components of estrogens, in the blood.
Testosterone Total Serum Test
Testosterone testing is used in the evaluation of androgen excess or deficiency related to gonadal function, adrenal function, or tumor activity in men and woman. Testosterone is believed to play an important role in bone and muscle strength and libido in women.
Progesterone Blood Test
The Progesterone Blood Test helps determine the cause of infertility in men and women, track ovulation, and help diagnose an ectopic or failing pregnancy.
Testosterone Free (Direct) and Total Testosterone Te…
A Testosterone Free (Direct) and Total Testosterone Test determines the level of free and total testosterone.
Free T3 and Free T4 Blood Test Panel
Free Tri-iodothyronine (T3) Serum and Thyroxine (T4) Free Direct Serum.
Prolactin Serum Test
The Prolactin Test is the first test for the work-up of galactorrhea (inappropriate lactation) also useful in the diagnosis of headaches and visual disturbances.
Thyroid Peroxidase Antibodies (TPO) Blood Test
A TPO Blood Test provides a differential diagnosis of hypothyroidism and thyroiditis.
Dehydroepiandrosterone Sulfate (DHEA-S) Blood Test
A DHEA-S Blood Test determines adrenal gland function.
Insulin-like Growth Factor (IGF-1) Blood Test
A IGF-1 Blood Test is ordered to help diagnose the cause of growth abnormalities and to evaluate pituitary function.
Follicle-stimulating Hormone (FSH) and Luteinizing H…
FSH and LH tests for infertility in both men and women.
Thyroxine (T4) Free Direct Serum Test
A T4 Free Direct Serum Test is ordered to help in evaluating thyroid gland function.
Parathyroid Hormone (PTH) Intact Blood Test
A PTH Intact Blood Test diagnoses parathyroid disease and other diseases of calcium homeostasis; monitoring patients undergoing renal dialysis.
Sex Hormone Binding Globulin (SHBG) Serum Test
The SHBG Serum Test helps in evaluating the status of a patient’s androgens (male hormones).
Cortisol Blood Test, AM
A Cortisol Blood Test measures the level of the hormone cortisol in the blood in the morning is when cortisol is at its peak.
Cortisol Blood Test, Random Serum
This Cortisol Blood Test detects excess or deficient cortisol production.
Estrogens Blood Test, Total
An Estrogens Blood Test is ordered to test for hormone imbalance in women and men.
Dihydrotestosterone (DHT) Blood Test, LC/MS
A Dihydrotestosterone (DHT) Blood Test, LC/MS checks dihydrotestosterone levels.
Adrenocorticotropic Hormone (ACTH) Blood Test
The ACTH blood test evaluates symptoms associated with excess or deficient cortisol.
Tri-iodothyronine (T3) Blood Test
The T3 Blood Test is ordered to help in evaluating thyroid gland function and in the diagnosis of hyperthyroidism.
Iodine Blood Test
An iodine blood test monitors exposure to iodine; evaluate for iodine deficiency disorders (IDDs), excessive iodine intake, or iodine in the workplace.
Estradiol (E2) Blood Test, Sensitive, LC/MS-MS
The E2 Blood Test, Sensitive, LC/MS-MS, This sensitive estradiol assay is designed for the investigation of infertility.
Prostate-specific Antigen (PSA) Hormone Blood Test P…
PSA plus Testosterone Total & Free and Estradiol.
Testosterone Free (Direct) Serum Test
A Testosterone Free (Direct) Serum Test is used in evaluation of hirsutism and masculinization in women and evaluation of testicular function in men.
Testosterone Total Blood Test, Male Only
The Testosterone Total Blood Test, Male Only measures Testosterone levels in the blood
Follicle-stimulating Hormone (FSH) Blood Test
The FSH Blood Test is often used in conjunction with other tests in the workup of infertility in both men and women.
Human Growth Hormone (HGH) Serum Test
Pituitary function test useful to diagnose hypothalamic disorder, hypopituitarism, acromegaly, and ectopic growth hormone production by neoplasm.
Thyroxine (T4) Blood Test
The Thyroxine Blood Test is a thyroid function test.
Anti-Mullerian Hormone (AMH) Serum Test
An AMH Serum Test is used in evaluating ovarian function and fertility issues in women.
Testosterone Free (Dialysis) and Total Testosterone …
The testosterone free (dialysis) and total testosterone test determines the level of free and total testosterone. The levels reported for this test are determined using different methodologies than the normal free and total testosterone tests.
Pregnenolone Blood Test, LC/MS-MS (Endocrine Science…
A Pregnenolone Blood Test measures the level of pregnenolone in your blood.
Estrone (E1) Blood Test
An Estrone (E1) Blood Test measures estrone levels of the blood in women.
Testosterone Replacement Therapy (TRT) Blood Test Pa…
A TRT Blood Test Panel includes: Complete Blood Count, PSA Serum Total, Testosterone Total & Free.
Thyroid Antithyroglobulin Antibody (TAA) Blood Test
A Thyroid Antithyroglobulin Antibody (TAA) Blood Test helps diagnose an autoimmune thyroid disease and separate it from other forms of thyroiditis.
Leptin Blood Test
The Leptin test measures the amount of leptin in your blood and is used to figure body fat amount.
Cortisol Blood Test, PM
A Cortisol Blood Test measures the level of the hormone cortisol in the blood.
Luteinizing Hormone (LH) Serum Test
The Luteinizing Hormone Serum Test measures luteinizing hormone that is produced by the pituitary gland.
Aldosterone Blood Test, LC-MS
The aldosterone blood test is used to evaluate patients with hypertension and for the possibility of hyperaldosteronism.
Melanocyte-stimulating Hormone (MSH) Blood Test
A melanocyte-stimulating Hormone Blood Test is used to evaluate the levels of MSH in the blood. It controls the production of hormones, modulates the immune system, and controls nerve function, too.
Thyroid-stimulating Immunoglobulin (TSI) Blood Test
The TSI Blood Test aids in the diagnosis of autoimmune disorders which affect the Thyroid
17-Hydroxyprogesterone Blood Test, LC/MS-MS
A 17-hydroxyprogesterone blood test, LC/MS-MS is used to screen for, detect, and monitor treatment for congenital adrenal hyperplasia (CAH); sometimes to help rule out other conditions with similar symptoms.
Estriol (E3) Blood Test
An Estriol (E3) Blood Test evaluates fetal distress and placental function.
Dopamine Blood Test
A Dopamine Blood Test is useful in the measuring the amount of dopamine in the blood.
PTH Antibody Blood Test
This PTH Antibody Blood Test is used to help evaluate autoimmune disorders involving parathyroid gland that may result in the production of anti-PTH & hypo-parathyroidism.