A year or more has passed, and you're still not pregnant. At this point, it may be time to investigate why, and that could mean testing for various causes of infertility. Here are the basics of what you can do.
Instructions
Test for Infertility
1. First, talk with your partner about how much, if any, testing you're willing to do. Some of these diagnostic tools to determine causes of infertility can be invasive, expensive, time-consuming or all of the above. Decide together how far to go, come up with a plan, and stick to it.
2. Determine whether you need the testing. For example, women who have used birth control within the last year might still have the drug in their system, therefore preventing pregnancy from occurring. Also, examine when in the women's menstrual cycle intercourse takes place. The most fertile period is one to two days before ovulation, so be sure that window isn't missed.
3. First, talk to your primary care physician. He may take an extensive medical history, inquire about the regularity of your period and possibly order blood work to check for a variety of flags indicating a condition causing infertility. For example, an elevated cholesterol level may indicate the patient has polycystic ovarian syndrome (PCOS), a leading cause of infertility in women.
4. Set an appointment with your OB/GYN for a checkup and discussion. She may perform an ultrasound on the ovaries to check for cysts, endometriosis or other issues; take a pap smear; perform a pelvic exam; and inquire about various aspects of daily life and family history. Your doctor may also recommend testing for LH (lutenizing hormone) and progesterone levels to determine whether the woman is actually ovulating. In addition, tests for TSH (thyroid stimulating hormone) and prolactin levels, which can also indicate ovulation problems, may also be required.
5. Simultaneously, men should also be tested by a urologist, for any problems that might contribute to the lack of pregnancy. Semen analysis, which checks for sperm count and how well the sperm move, should be conducted, as well as testosterone levels and testing for any STD's
6. If those inital tests do not render a diagnosis or cause for infertility, a doctor may suggest a hysterosalpingogram (HSG). During the HSG, a dye is injected through the vagina and x-ray pictures are taken while the dye flows through the fallopian tubes and uterus to determine whether a blockage may be present. Another use of the HSG might be to determine a uterine problem, such as abnormalities in shape and size, fibroids or other obstructions that could prevent implantation into the uterus. In some cases, a laparoscopy may be ordered to check for adhesions, fibroids or an infection of the uterus. While effective, the laparoscopy isn't performed unless absolutely necessary, since it is performed through an incision and requires general anesthesia.
7. At this point, most cases can be solved with either medication, surgical intervention or a combination of the two. If after the above tests there is still no diagnosis for infertility, a doctor may order antibody testing to determine if a woman's system may contain sperm antibodies or genetic testing may be recommended as well to determine causes for infertility.
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