Understanding Fertility Problems: A Woman’s Evaluation

To help your healthcare provider look for the cause of fertility issues, you will have an evaluation. They will ask about your health history. They will give you a physical exam. And you'll have some basic tests. If needed, your provider may suggest a procedure. This will allow them to look at your reproductive organs.

Gender words are used here to talk about anatomy and health risk. Please use this information in a way that works best for you and your provider as you talk about your care.

Health history

Your healthcare provider will ask about factors that can affect your ability to get pregnant They’ll ask about your health and lifestyle. They may ask how often you have sex. They may ask about your menstrual cycle.

Tell the healthcare provider what medicines, vitamins, or herbs you take. Also tell them if you have ever had any of these:

• Surgery

• A past pregnancy

• A pelvic infection

• A sexually transmitted infection

Physical exam

A physical exam helps your healthcare provider learn about your health. It includes a pelvic exam. This is done to check for swelling, infection, or other problems. Your hormone function is also checked. To do this, your provider looks at your breast development, body fat, and body hair.

Basic tests

You will likely have some basic tests. These include blood tests.

Blood tests can be used to check these:

• Hormone levels (FSH, LH, AMH, estrogen, progesterone, prolactin)

• Blood sugar and insulin levels

• Tests for current or past pelvic infection

• Thyroid function

In some cases, you may have a test to check the health of your cervix. This is called a Pap test. This is a swab of cells from the cervix. The cells are sent to a lab. They’re checked for signs of infections that can affect fertility.

Imaging tests

Your healthcare provider may advise that you have imaging tests. These show the reproductive organs in more detail. These tests may be done in your provider’s office. Or they may be done in a hospital or surgery center. In most cases, they cause little or no discomfort.

• HSG (hysterosalpingogram). This is an X-ray test. It's used to view the shape of the uterus. It can show if the fallopian tubes are open. For the test, the healthcare provider puts contrast fluid in the uterus and fallopian tubes. The contrast makes it easier to see problems on the X-rays.

• Ultrasound. This uses painless sound waves. They make images of internal organs. This can help show problems with the ovaries or uterine lining.

• Sonohysterogram. This is an ultrasound done with sterile saltwater (saline) solution. The saline is placed in the uterus. The saline makes it easier to view the inside of the uterus.

Other tests

If needed, your healthcare provider may suggest other tests. Some can be done in your provider’s office. Others are done in a hospital or surgery center. For some procedures, you’ll be given anesthesia to prevent discomfort.

• Hysteroscopy. This is done with a small, lighted tube called a hysteroscope. The scope is used to look at the inside of the cervix and uterus. It's usually done just after your period.

• Laparoscopy. This is a type of surgery. It can help show problems on the surface of the reproductive organs. The provider puts a thin, lighted tube device called a laparoscope into your body. They look at your reproductive organs through the scope.