Couples who have been trying unsuccessfully to conceive for some period of time should seek medical evaluations to determine if a diagnosis of infertility is appropriate.
For women younger than 35 years of age, twelve months of trying to get pregnant naturally is a recommend length of time before consulting a physician.
Women older than 35 should request an initial examination after six months of trying to get pregnant. For this age group there is a sense of urgency due to declining fertility.
A couple with prior knowledge of conditions such as irregular menstrual cycles or a history of tubal infections should consider basic examinations sooner.
It is important to see a specialist, such as a reproductive endocrinologist, a urologist, or in some cases an OB/Gyn for a complete fertility work-up and diagnosis.
Both partners undergo infertility examinations. The results of early evaluations will vary for each couple. Prescribing simple fertility medications may succeed for some while others will need to undergo more intensive testing.
A complete medical history and physical exam are the first steps in diagnosing a fertility problem. Blood tests and urine tests check hormone levels, and a Pap smear to check the health of the cervix may be included.
Additional diagnostic tests for infertility might include:
- Urine tests
- A basal body temperature test to determine if eggs are being released from the ovaries
- An endometrial biopsy, allows the doctor to examine a tissue sample from the uterine lining. This shows if eggs have been released and whether enough progesterone is being produced.
- An ultrasound looks for fibroids and cysts in the uterus and ovaries
- An X-ray that looks inside the fallopian tubes or uterus called a hysterosalpingogram (HSG)
- A post-coital test samples the mucous from the woman’s vagina. The test will tell the doctor if the man’s sperm can survive in the woman’s cervical mucous.
The infertility diagnosis is a step-by-step process that can take from one to three months. These evaluations may determine the cause of infertility and the most appropriate treatment to help them get pregnant.