Highlights
- You and your partner will both need tests to work out why you can’t get pregnant.
- Your doctor may refer you for fertility tests, which will usually happen in a hospital or at a fertility clinic.
- Fertility treatments try to either fix your infertility issue or use an assisted reproductive technology to help you become pregnant.
- The treatment options depend on your cause of infertility and individual circumstance.
- Treatments vary in how much they cost and how well they work.
In This Article
- How infertility is tested
- Fertility tests for men
- Fertility tests for women
- Fertility treatments available
- Tools and Assistance
How Infertility Is Tested
Not being able to become pregnant can be upsetting and difficult to deal with. Your doctor can arrange tests to better understand you and your partner’s fertility.
Infertility can be related to problems involving either partner, although sometimes the reason is never found. Your doctor can refer you for fertility tests, typically performed in a hospital or fertility clinic.
Depending on the test results, a number of treatment options may be available.
Infertility treatment can bring hope, but success is not guaranteed. It also has physical, emotional, and financial costs.
Fertility Tests for Men
Semen Analysis
In many cases, fertility problems are related to sperm issues. Sometimes:
- There are not enough sperm.
- The sperm are not moving properly.
- The sperm shape is not typical.
A semen analysis is performed using a sperm sample, which is then taken to a laboratory for testing.
Hormone Tests
A blood test can check hormone levels that control fertility, such as testosterone.
Imaging Tests
Imaging tests may include:
- Ultrasound
- MRI
- X-rays
These can help detect problems in the testicles or locate possible tumours that may affect hormone production.
Testicular Biopsy
A small piece of testicular tissue is removed and examined to check for conditions linked with infertility. This is a rare test because most diagnoses can be made using other methods.
Genetic Testing
Sometimes infertility is caused by genetic conditions. Your doctor may recommend genetic testing to check for hereditary issues.
Fertility Tests for Women
There is no single test that can determine a woman’s fertility completely.
Ovulation Testing
Blood or urine tests measure luteinising hormone (LH), which rises shortly before ovulation. Hormone issues can contribute to ovulation problems.
Irregular or absent periods are also signs of ovulation issues. Polycystic ovary syndrome (PCOS) is one of the most common reasons for ovulation irregularities.
Ovarian Reserve Testing
Ovarian reserve testing assesses fertility treatment potential. This is usually done by measuring anti-Müllerian hormone (AMH) levels through a blood test.
AMH indicates the number of eggs remaining in the ovaries, but not their quality. Low AMH does not always mean low fertility, especially in otherwise healthy younger women.
Other Hormone Tests
Blood tests can determine whether thyroid hormone levels or other reproductive hormones may be affecting fertility.
Test for Chlamydia
Chlamydia is a sexually transmitted infection that can cause pelvic inflammatory disease and fertility problems. Testing may involve:
- A urine test
- A cervical swab (can be self-collected)
Ultrasound Scan
An ultrasound can help examine the ovaries, uterus, and fallopian tubes. A transvaginal ultrasound may be used if consent is given.
Conditions such as endometriosis or fibroids may interfere with pregnancy.
Imaging of Fallopian Tubes
Fallopian tube blockages can prevent eggs from reaching the uterus.
A dye may be injected through the cervix during an X-ray to detect blockages — this test is called a hysterosalpingogram (HSG).
An ultrasound alternative called HyCoSy may also be used.
Laparoscopy
If conditions like pelvic inflammatory disease or endometriosis are suspected, a keyhole surgery (laparoscopy) may be performed. A laparoscope allows the doctor to view the uterus, fallopian tubes, and ovaries.
Fertility Treatments Available
Fertility treatments aim to:
- Fix underlying infertility issues
- Use assisted reproductive technologies such as IVF
Treatment depends on the cause of infertility and varies in cost and effectiveness.
Surgery
Surgery may be used to treat blocked or damaged fallopian tubes or remove growths such as fibroids or endometriosis.
Intrauterine Insemination (IUI)
Semen is collected and inserted into the uterus around the time of ovulation.
IUI is useful when:
- The sperm quality or quantity is reduced
- Cervical mucus is too thick
IUI is less invasive and more affordable than IVF.
Ovulation Induction (OI)
OI involves taking medicines to help eggs grow, mature, and be released. It is suitable when ovulation issues exist but fallopian tubes are normal.
Treatment may involve timed intercourse or IUI.
In Vitro Fertilization (IVF)
IVF involves stimulating the ovaries, retrieving eggs, fertilizing them with sperm in a dish, and placing an embryo into the uterus.
IVF may also be suitable for:
- A range of infertility issues
- Same-sex couples
- Single parents
- Individuals wishing to avoid passing on genetic conditions
Preimplantation genetic testing may be performed on embryos.
Intracytoplasmic Sperm Injection (ICSI)
A single sperm is injected into an egg. This is often used when sperm quality or quantity is low.
Sperm Harvesting Procedures
If semen contains no sperm, sperm may be collected directly from the testicles and used for IVF or ICSI.
Tools and Assistance
Fertility Specialists and Clinics
Specialists in reproductive medicine provide testing and treatment options tailored to individual needs. Clinics may offer services ranging from diagnostics to IVF and other fertility treatments.
Fertility Support Groups and Counseling
Infertility can be emotionally challenging. Support groups and counseling services can help individuals and couples manage stress and navigate treatment decisions.
Online Resources
Various online platforms provide information on fertility tests, treatment options, and patient experiences to help individuals feel more informed when talking with healthcare providers.
Financial Assistance for Fertility Treatments
Fertility care can be costly. Some organizations, programs, or insurance plans may offer financial assistance or partial coverage for treatments such as IVF. It is important to explore available options and discuss costs with your fertility clinic or healthcare provider.
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