Inability of a couple to conceive despite regular, unprotected sex for a period of more than one year makes them infertile and they need to look for timely diagnosis and treatment for the problem. The reasons could be varied, involving male or female infertility, and even combined infertility in some cases. Comprehensive physical examination and medical assessment are recommended to establish the cause of infertility and decide the line of treatment accordingly.
While it is important to test both the partners for finding the root of infertility, here we will be discussing all the screening tests for diagnosing female infertility. Though the woman would generally look up to a gynaecologist at the first instance of suspected infertility, it is better to see an experienced infertility specialist who is better equipped to tackle the situation.
All about diagnosing female infertility
The infertility specialist will start with some vital questions to sum up the reproductive capacity of the patient; these questions may be pertaining to the medical history, lifestyle, menstrual cycle, previous pregnancy, birth control practices, any sexual diseases, regular prescription medications being taken and other health issues that have been a part of past or present. It is also important to know whether the patient is exposed to environmental toxins at home or at workplace. Following this, comes the initial physical examination of the reproductive organs. Here are some diagnostic tests that may be recommended for women combating fertility issues:
A thorough pelvic examination is the preliminary physical test to establish any abnormality in the reproductive organs. The specialist will check the uterus, ovaries and fallopian tubes to feel for any abnormal growths such as cysts, fibroids and endometriosis. Similarly, examination of the genital area can help to establish presence of sexually transmitted infections like gonorrhea, genital herpes and Chlamydia. A Pap smear test, which involves gentle scraping of the cervical tissue, may be recommended for checking out the possibility of cervical cancer.
Ovulation is undoubtedly the most important parameter of fertility and this is the reason why it has to be tested first hand in infertility cases. Diagnostic tests involve the study of timing and accuracy of ovulation, ovarian functioning and uterine functioning.
- Ovulation Tracking involves charting of basal body temperature to determine the time a woman ovulates during her monthly cycle. This is something that every woman planning conception would probably do even before the specialist would ask her to, because it can be useful for determining the exact time when the couple should try for pregnancy.
- Hormonal tests are simple blood tests which are done to evaluate the hormone levels of the woman, as any abnormality detected could point out to the reasons of female infertility. These include testing of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH), both done on day 3 of the menstrual cycle. A thorough study of the levels of progesterone and estradiol is also conducted to check out whether the female’s reproductive functioning is normal or not.
Post Coital Test (PCT)
Post coital test is carried out to check the consistency of cervical mucus, whether the sperm would be able to survive and travel through it to reach the egg for fertilization. This test, as the name suggests, is conducted a few hours after the sexual intercourse and involves microscopic screening of the cervical mucus to rule out the possibility of cervical mucus hostility (hyperlink with the blog on cervical mucus hostility).
Transvaginal Ultrasound Scan
Transvaginal ultrasound scans are carried out to evaluate the condition of the ovaries and the uterus, for establishing whether the follicular development is proper and measuring the thickness of the endometrial lining. The doctor would recommend this test for the cases where there is doubt about the viability of the ovaries and uterus.
Another common screening test for female infertility is endometrial biopsy, which involves scraping of the endometrial tissue and testing its thickness to determine whether it is good enough to support embryo implantation. The test is conducted just before the period and can cause some pain and/or discomfort. The doctor has to ensure that the woman is not pregnant before performing this test otherwise it may harm the baby.
Tubal blockage is one of the most common infertility problems that women come across and Hysterosalpingogram is a test used to indicate this issue. This test is carried out by injecting a dye through the cervix so that it reaches the uterus and the fallopian tubes. An x-ray is then performed to detect any blockage in the fallopian tubes or uterine abnormalities.
If the HSG test returns abnormal results, the specialist may order further testing through a hysteroscopy for a detailed study of the uterus. The test is done with a hysteroscope, a telescope-like instrument passed through the cervix to reach the uterus. The specialist uses it to have a proper look at the internal anatomy of the uterus and detect any abnormal growth or scarring therein. Image can also be taken for future references.
Further testing may be needed in complicated cases of female infertility. Laparoscopy is a minimally invasive surgical procedure which is done under general anesthesia and involves a small incision on the abdomen. A laparoscope is then inserted into the abdomen for studying the reproductive organs and checking for conditions such as pelvic adhesions, scarring and endometriosis. Furthermore, these abnormalities can be removed using laser technique so that the woman can become pregnant after recovering from the laparoscopy.
While diagnostic tests are crucial for identifying infertility issues, they are not necessary for all cases. Therefore, it is important for the patient to be aware so that they may not have to undergo expensive and uncomfortable tests unless absolutely essential. At the same time, the fertility specialist also needs guide the patient in an honest and open manner.
Gaudium IVF is the top IVF clinic in Delhi where patients are offered comprehensive fertility treatment and gynaecological care. From diagnostic testing to high-tech Assisted Reproductive Techniques, the clinic offers everything under one roof. Contact here for free second opinion from Dr Manika Khanna, the leading infertility specialist in Delhi.