If you are wondering why you’ve been unable to get pregnant after trying for a year or more, you may want to take a fertility test. Difficulty becoming pregnant does not mean you are infertile. A fertility test will help your doctor determine the underlying cause of your challenges with pregnancy. Your ob-gyn may start the initial evaluation for fertility; however, your doctor may refer you to a reproductive endocrinologist who is a specialist in fertility treatment. Solv can help you locate an expert reproductive endocrinologist near you to perform the fertility test and schedule an appointment right away.
Who should get a fertility test?
The American College of Obstetricians and Gynecologists recommends:
- Fertility tests for anyone who is at risk for infertility or infertile
- Expedited fertility tests for women above 35 years
However, an immediate fertility test is recommended by the American College of Obstetricians and Gynecologists if you:
- Are above 40 years
- Have any conditions that are known to cause infertility
- Experience oligomenorrhea—inconsistent or irregular menstruation
- Have suspected or known tubal, uterine, or peritoneal disease
- Experience amenorrhea—the absence of menstruation
- Have stage III or IV endometriosis, a disorder with endometrial tissue outside of the uterus
Your response to donor insemination can be an indication of the need for a fertility test. If you are younger than 35 and fail to get pregnant within 12 months of therapeutic donor insemination or older than 35 and fail to get pregnant within 6 months, you may need fertility tests, reports the American College of Obstetricians and Gynecologists.
How to get a fertility test?
You can get a fertility test from your ob-gyn. However, your primary care provider may refer you to a reproductive endocrinologist, a specialist with expertise and training in reproduction, for the evaluation and treatment of infertility. Solv can help you find a top-rated reproductive endocrinologist close to you to help you schedule an appointment immediately.
What to expect at your initial appointment
During your initial appointment with the reproductive endocrinologist, you can usually expect them to obtain a thorough reproductive, medical, and family history and conduct a physical examination.
You can expect your doctor to ask about the duration of infertility, menstrual history, obstetrical history, timing, and frequency of sexual intercourse, as well as your social history. Your doctor will inquire about smoking, alcohol consumption, exercise, occupation, diet, and illicit drug use.
According to the National Library of Medicine (NLM), acute and chronic infections in the abdomen and pelvis can lead to tubal/pelvic adhesions. These adhesions account for a significant amount of infertility. You can expect your doctor to ask about a history of sexually transmitted diseases (STDs). According to the American Society for Reproductive Medicine, the initial visit is an appropriate time to provide prepregnancy counseling and screen for applicable genetic conditions.
The NLM notes that you can expect the healthcare provider to take your vital signs and measure your body mass index (BMI). Your doctor will also typically evaluate your thyroid, examine your breasts for milky discharge, and examine your skin and genitalia for signs of androgen excess. The physical examination will include an evaluation of the vagina and cervix for abnormalities, pelvic tenderness or masses, and an enlarged or irregular uterus. According to the NLM, a bedside transvaginal ultrasound may be done during the initial visit.
How can I tell if I am infertile
According to Planned Parenthood, infertility may be difficult to identify. The only signs that suggest infertility are difficulty getting pregnant or keeping a pregnancy. The definite way to determine if you have infertility is to consult a doctor and have a fertility test done.
Types of fertility tests
Fertility tests typically focus on ovarian function, structural abnormalities, and ovarian reserves.
How to assess ovarian function
The menstrual history may provide information about ovarian function. Your doctor will ask questions about your menstrual flow, the regularity of your cycle, and symptoms of breast tenderness, fatigue, and bloating to assess ovulation. You can use an at-home luteinizing hormone (LH) predictor kit to identify a mid-cycle rise in LH levels. The surge in LH is indicative of ovulation. According to the NLM, measurement of the levels of hormones like progesterone a week before your menses may provide evidence of ovulation and ovarian function.
How to measure ovarian reserve
Ovarian reserves refer to the capacity of the ovaries to produce eggs that can become fertilized. Women with low ovarian reserves may have regular menses but a diminished response to ovarian stimulation. Your doctor may perform a biochemical analysis and an ultrasound of the ovary to assess your ovarian reserve. According to the American Society of Reproductive Medicine, several measurements of hormones, including the basal follicle-stimulating hormone (FSH) and estradiol, and antimullerian hormone, provide information about the ovarian reserve. Your doctor will obtain a level of basal FSH and estradiol between the second and fourth days of your menstrual cycle.
How to assess structural abnormalities
According to the American Society of Reproductive Medicine, structural abnormalities like blocked tubes, pelvic abnormalities, cervical disorders, and uterine abnormalities affect infertility. Your doctor may need to make an assessment:
- Your doctor may need to perform tests to evaluate structural abnormalities. A cervical examination may be done to identify the narrowing of the passage or chronic inflammation.
- Uterine abnormalities, including polyps, fibroids, and adhesions, are common in women with fibroids. According to the American Society of Reproductive Medicine, ultrasound is the best test for assessing the anatomy of the uterus to identify abnormalities. Your doctor may use an instrument called hysteroscopy to evaluate the uterine cavity and remove lesions. A saline infusion sonogram (SIS) is a less invasive way to view uterine abnormalities.
- Tubal disease can cause a blockage in your fallopian tubes and prevent pregnancy. Your doctor may perform an imaging study called hysterosalpingography to evaluate the patency of your tubes.
- Peritoneal factors that cause infertility include pelvic or adnexal adhesions and endometriosis. According to the NLM, a laparoscopy is done when there is suspected endometriosis, pelvic adhesions, or disorders within the pelvis. Your doctor may perform a transvaginal ultrasound to assess for endometriosis and laparoscopy to visually pelvic abnormalities that impair infertility.
Find Fertility Testing near you
Fertility Testing FAQs
What are the causes of infertility?
Among infertile couples, female infertility is a more common cause of infertility than male infertility. The most common identifiable causes of infertility are ovulatory disorders, endometriosis, pelvic adhesions, hyperprolactinemia, tubal blockage, and other tubal/uterine abnormalities. A quarter of all the known instances of female infertility are caused by ovulatory disorders.
Does age affect fertility?
A woman has a 25–30% chance of becoming pregnant in her 20s or early 30s but that changes with age. Fertility declines in the early 30s, and the decline progresses faster after 37. A woman between 40 and 44 years may have a 30% chance of infertility.
How long does fertility testing take?
Infertility testing involves multiple types of tests including blood tests done at different times during the menstrual cycle. You can expect to complete most fertility tests in a few menstrual cycles.
How do you cope with infertility?
Having difficulty getting pregnant is a frustrating and emotionally challenging situation. It is important to maintain your emotional health as you try to get pregnant. Coping strategies may include exercising, relaxing, reading, meditating, and going for walks. You can use support systems like friends, therapists, and partners to cope with infertility.
How will my doctor treat infertility?
There are different types of treatment for infertility, and your doctor will choose the most appropriate one based on the cause. Your doctor may ask you to make changes to your lifestyle or treat you with medication, hormone therapy, or surgery.
Can I get pregnant if I have infertility and do not get treatment?
Without treatment, 1.3% to 3.8% of women with unexplained infertility will get pregnant. However, the pregnancy rate increases to 4% with intrauterine insemination (IUI) alone, 5.6% with clomiphene citrate (CC) treatment, 7.7% with gonadotropins alone, 8.3% with CC and IUI, 17.1% with gonadotropins and IUI, and 20.7% with in-vitro-fertilization (IVF).
What if the doctor does not find the cause of my infertility?
In some cases, the cause of infertility may not be identified. Unidentified infertility is known as unexplained infertility. Your doctor may prescribe clomiphene citrate, a medication that stimulates the release of the gonadotropin hormone, to treat your infertility with an unknown cause.
Will my insurance cover fertility tests?
Your insurance company may cover the cost of your fertility test. You may need to call your insurance company to find out details about coverage for fertility tests prior to testing.
How can I find a place to get a fertility test near me?
The best way to find a top-rated reproductive endocrinologist or testing center for a fertility test is to use Solv. You can identify a leading reproductive endocrinologist in your area and schedule an immediate appointment right from their website.
Solv has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
- Evaluating Fertility (2022)
- Fertility evaluation of infertile women: a committee evaluation (2022)
- Female fertility (May 26, 2022)
- Infertility Workup for the Women’s Health Specialist (2022)
- Weight, fertility and pregnancy (2022)
In Good Health
Tips, advice, news—your resource to stay healthy and safe while improving your experience with healthcare providers when you need them.
Visualizing convenient care: Solv’s new illustrations
At Solv Health, we believe everyone deserves to be free from the stress of everyday healthcare. That’s why it’s...Read more
XBB.1.5: A new Covid variant spreads across the US. What do you...
The holidays may have ended, but COVID continues to loom large. As you navigate the new year, the last thing you...Read more
COVID habits worth keeping, and those you can leave behind
COVID made us rethink our daily routines to keep from getting sick and to protect others from the virus. But...Read more