The first step in diagnosing female infertility is determining whether ovulation is occurring at predictable intervals. When an egg is released, it causes a shift in the body's sex hormones.
This shift in sex hormones can be detected with these tests:
Early-morning core body temperature. You use a precise (basal body) thermometer to take your temperature first thing every morning. You will detect a slightly higher temperature after ovulation.
Ovulation predictor test. This is an over-the-counter urine test. It can predict egg release. A positive test means you have ovulated recently or are about to ovulate.
Vaginal mucus. You may be able to recognize changes in the appearance and consistency of your vaginal mucus. These changes signal hormone shifts that show ovulation has occurred.
Your doctor will examine your vagina and pelvic organs. A sample of mucus from your cervix and vagina may be tested for possible infection.
If necessary, blood tests may be used to:
Confirm normal ovulation
Show whether the ovaries are functioning well enough to release eggs
Measure the function of your thyroid, pituitary and adrenal glands
Other tests may also help to determine the cause of infertility. These examine the physical structure of pelvic organs.
Hysterosalpingogram. This is an X-ray study in which a liquid dye is injected into your uterus. It reveals problems such as polyps and fibroid tumors in the uterus. It can also reveal partial or complete blockage of the fallopian tubes.
Ultrasound. An ultrasound reveals the shape and size of the uterus. It gives some information about the uterine cavity or inner lining. An ultrasound can identify the shape and size of the ovaries and the presence of developing cysts.
Hysteroscopyand laparoscopy. These are surgical procedures performed by a gynecologist. Both procedures use a small video camera to view the pelvic organs.
During a hysteroscopy, your doctor can see the inside of your uterus. He or she can obtain biopsies. In some cases, the doctor can remove polyps, fibroids or scar tissue.
Laparoscopy allows your doctor to view the outside of your uterus and inspect your ovaries. Sometimes, it is possible to remove ovarian cysts or scar tissue during a laparoscopy.