An infertility work-up will involve tests to determine how well each of the systems involved in conception is working.
• To determine if and when you are ovulating (producing and releasing a mature egg during the menstrual cycle), you may be asked to chart your basal body temperature. This involves taking your temperature before getting out of bed each morning. A slight, sustained rise in temperature is an indirect indication that ovulation has occurred.
• You may also be asked to use an ovulation predictor kit at home.
• The doctor may check various hormone levels on specific days in your menstrual cycle, or monitor your body’s response to a dose of fertility medications.
A semen specimen will be analyzed for the number of sperm, their shape and movement. If the results are abnormal, a man may be examined by a urologist or tested for hormonal abnormalities or infection.
• To see whether the fallopian tubes are open, an X-ray (called a hysterosalpingogram or HSG) may be taken while the dye is injected into the uterus and tubes.
• Alternatively, a doctor might inject a saltwater solution and view the uterus and tubes using ultrasound (called a sonohysterogram). The tubes can also be observed during a surgical procedure.
The shape of the uterus is shown in an HSG. It can also be seen through a telescopelike device (hysteroscope) inserted through the vagina and cervix. An endometrial biopsy samples the uterine lining in the last half of the cycle to see if it is prepared for an embryo to implant. The thickness of the lining can also be measured using ultrasound.