If a couple fails to bear a child even after constant efforts to do so for more than a year then both partners would need to get a proper medical assessment done. This assessment would include a semen analysis of the male and also a testing for female infertility will be done.
Initial Fertility tests: Testing for female fertility is a long process, which includes many procedures which are carried out over a scheduled period of time.
The first issue to be dealt with is female ovulation. The specialist would conduct test and track your ovulation using either a fertility monitor or through fertility awareness. The next step would involve measuring the Luteinizing Hormone (LH) and your follicle stimulating hormone (FSH). Performed on the third day of the monthly cycle, this establishes a baseline for future test results.
Just before ovulation, there is a surge of LH, and you will be required to visit the clinic for further measuring tests.
This will be followed by more tests. A cervical mucus test would also be conducted. This is a postcoital test (PCT), which not only does bacterial screening, but also finds out if the sperms are able to penetrate and survive in the cervical mucus.
The fertility testing process also makes use of ultrasound tests to check the condition of the ovaries and uterus, find out how thick the lining of the uterus is, and also to monitor follicular development. Another ultrasound may be done after a few days to find out if an egg has been released.
The fertility test will also require certain hormone tests in order to ascertain the levels of various hormones, such as prolactin, progesterone, LH, Estradiol, free Testosterone and total Testosterone, which help in the reproductive process.
Additional fertility tests: If the above fertility tests and the semen analysis turn out to be normal, you may be asked to go in for further tests to determine infertility.
An x-ray, called the Hysterosalpingogram (HSG) will be taken of the uterus and fallopian tubes. This is done by injecting a blue dye through the cervix, thus enabling the radiologist to find if there is any blockage or some other major problem.
If the HSG indicates some problems, you will be required to get a hysteroscopy done. A hysteroscope, which is a narrow tube, will be inserted through the cervix to see if there are any growths, scarring or abnormalities in the uterus.
Sometimes, your doctor may advise a Laparoscopy, where a thin fiber optic telescope will be inserted through the abdomen, to allow a closer look as the ovaries, fallopian tubes and uterus.
You might also be required to get an endometrial biopsy to check for hormonal imbalance.