Fertility testing for women

By Constance McGraw, MPH

What is fertility testing for women?

Fertility testing for women refers to a series of diagnostic evaluations and assessments that are conducted to understand and evaluate a woman’s reproductive health and their ability to conceive a child. 

What is included in fertility testing for women?

• A discussion of medical history, frequently to assess any issues with ovulation or menstrual cycle
• Blood tests to check hormone levels and ovarian reserve (the number of potential eggs remaining in a woman’s ovaries).
•  Pelvic examination
•  Minimally invasive procedures, such as ultrasound imaging (sonogram), X-rays, and surgery, to check for structural causes of infertility

Who should consider fertility testing?

Women under the age of 35 who have been engaging in regular, unprotected intercourse with their partners for a year should consider fertility testing. For women aged 35 or older, this assessment is recommended after 6 months of trying to get pregnant.

Moreover, specific conditions and circumstances may prompt the need for fertility testing, including:

• Those diagnosed with reproductive system issues involving the fallopian tubes, ovaries, or uterus.
•  Individuals experiencing irregular menstruation (with more than 35 days between periods), heavy bleeding, or absent periods.
• Women with a history of recurrent miscarriages.
• Women who have a background of pelvic inflammatory disease, pelvic pain, or endometriosis.
• Partners with suspected or identified male infertility.

What is infertility?

Infertility, as defined by the October 2023 American Society for Reproductive Medicine guidelines, refers to:

• The inability to achieve a successful pregnancy based on a patient’s medical, sexual, and reproductive history, age, physical findings, diagnostic testing, or any combination of those factors.
• The need for medical intervention, including, but not limited to, the use of donor gametes or donor embryos in order to achieve a successful pregnancy either as an individual or with a partner.
•  In patients having regular, unprotected intercourse and without any known etiology for either partner suggestive of impaired reproductive ability, evaluation should be initiated at 12 months when the female partner is under 35 years of age and at six months when the female partner is 35 years of age or older.

What are infertility diagnostic tests?

Infertility diagnostic tests provide a more in-depth understanding of fertility issues beyond the hormonal blood work tests. These advanced evaluations are typically performed by fertility clinics or specialists and may include the following:

Hysterosalpingogram (HSG): This X-ray procedure examines the uterus and fallopian tubes and involves the injection of a dye to detect blockages or other issues.

Sonohysterogram (SHG): Also known as a saline infusion sonogram (SIS), this procedure provides a detailed view of the uterus, going beyond what a traditional ultrasound can reveal.

Laparoscopy: A surgical procedure performed under anesthesia, which involves the insertion of a small telescope (laparoscope) through a small abdominal incision to examine the fallopian tubes, ovaries, and uterus. This procedure is valuable in identifying abnormalities, including endometriosis, pelvic adhesions, or blocked fallopian tubes that may hinder fertility.

Understanding your fertility is an important step in the journey towards achieving your family planning goals. If you have questions or concerns about fertility testing, reach out to a fertility clinic or specialist near you for expert guidance.

‍