When a couple has been unsuccessful at achieving pregnancy after one year, both partners need to go through a comprehensive physical and medical assessment. Tests for female infertility and a semen analysis should start immediately. Because male factors account for approximately 50% of all infertility cases, it is important to examine both partners for possible infertility issues. At home semen analyis kits are available to help encourage male testing. The various at-home kits make men more comfortable with testing in the privacy of their own home. Shop male testing Ideally, you will have already begun tracking your ovulation through fertility awareness or a fertility monitor. This will provide your reproductive specialists with valuable information about your ovulation. Usually the first question regarding female fertility is whether you are ovulating or not.
The first test performed by your fertility specialists involves measuring your follicle stimulating hormone (FSH) and luteinizing hormone (LH) to establish a baseline. This is performed on the third day of your cycle. This test is performed during your first visit.
You are able to take follicle stimulating hormone tests from the privacy of your home or if you are looking to get information prior to making an appointment with a fertility specialist. Shop FSH tests now
Your second visit will occur on the day of the LH surge, which is before ovulation in most cases. During your first cycle, it is common for your fertility specialists to perform the following tests:

  • Cervical mucus tests: This involves a postcoital test (PCT) which determines if the sperm is able to penetrate and survive in the cervical mucus. It also involves a bacterial screening.
  • Ultrasound tests: This is used to assess the thickness of the lining of the uterus (endometrium), monitor follicle development, and check the condition of the uterus and ovaries. An ultrasound may be conducted two to three days later to confirm that an egg has been released.
  • Hormone tests: These tests are done to assess the various hormone levels that contribute to the reproductive process. These hormone tests include the following:
Luteinizing Hormone
Follicle Stimulating Hormone
Free T3
Total Testosterone
Free Testosterone
If both the semen analysis and the above testing return normal results, there is also additional testing that your fertility specialists may recommend. These tests include any of the following:

  • Hysterosalpingogram (HSG): This is simply an x-ray of your uterus and fallopian tubes. A blue dye is injected through the cervix into the uterus and fallopian tubes. The dye enables the radiologist to see if there is blockage or any other problem.
  • Hysteroscopy: This is a procedure that may be used if the HSG indicates that there may be problems. The hysteroscope is inserted through the cervix into the uterus, which allows your fertility specialist to see any abnormalities, growths, or scarring in the uterus. The hysteroscope allows your physician to take pictures which may be used for future reference.
  • Laparoscopy: This is a procedure which uses a narrow fiber optic telescope. The laparoscope is inserted through a woman’s abdomen to look at the uterus, fallopian tubes, and ovaries. Your physician will be checking for endometriosis, scar tissue, or other adhesions. It is important to confirm that you are not pregnant before this test is performed.
  • Endometrial biopsy: This is a procedure which involves scraping a small amount of tissue from the endometrium just prior to menstruation. This biopsy is performed to assess whether there is a hormonal imbalance or not. It is important to confirm that you are not pregnant before this test is performed.
These tests are not mandatory and your fertility specialists will know which tests best fit your situation.