The initial work-up for couples struggling with infertility is fairly standard but will be tailored to each couple’s needs based on their reproductive history.
Certain tests are required prior to any treatment, including tests to look at:
- Ovulation
- Basal body temperature graphs (BBT)
- Blood progesterone level
- Daily monitoring of Estradiol (E2) and Leuteinizing hormone (LH)
- Urine LH predictor kit
- Other endocrine tests (Prolactin, Thyroid, FSH, AMH, Testosterone)
- Male Factor
- Semen analysis
- Sperm chromatin structure assay test (DNA fragmentation)
- Anti-sperm antibodies (MAR test)
- Tubal Factor
- Hysterosalpingogram (HSG)
- Sono-hysterosalpingogram (Sono-HSG)
- Diagnostic laparoscopy and dye insufflation
- Uterine Factor
- Ultrasound/3-D Ultrasound
- Sono-hysterosalpingogram (Sono-HSG)
- Hysterosalpingogram
- Hysteroscopy +/- laparoscopy
In-vitro fertilization (IVF) is also an important “test”, which also offers the best chance for pregnancy. It is the only procedure that can determine egg quality and the sperm’s ability to fertilize. It can also gauge embryo and blastocyst quality and determine if an underlying implantation problem is present. Most questions regarding “unexplained” infertility are answered following 1 IVF cycle.