Common Tests Used to Evaluate Fertility in the Female Partner

 Basal Temperature Records
In this simple method, a woman will carefully chart her body temperature each morning. The measurement should be made immediately upon awakening, before arising and with a minimum of muscle activity by the woman. The thermometer should be kept already shaken down (if applicable) and ready to use. There is a slight rise in the body's basal temperature at the time of ovulation, so that recording daily temperatures can help to pinpoint this critical time in the cycle.

Cervical Mucus Tests

• Ferning test. Cervical mucus collected near the time of ovulation will, when smeared onto a glass microscope slide, dry into a pattern that looks like the fronds of a fern if estrogen levels are normal. This kind of mucus makes a more hospitable environment for sperm.
• Postcoital test. This test is used to evaluate whether viable sperm are arriving at the opening to the womb. The test must be performed just before ovulation. There should be an increased amount of thin, clear, elastic mucus at this time, conditions most favorable to the migration of sperm into the uterus. To be considered a satisfactory test, a drop of cervical mucus, collected and viewed under the microscope within 12 hours of intercourse, should show five or more active, swimming sperm. Sometimes this test will also detect an elevated number of white blood cells, a finding that could indicate infection of the female cervix or the male's prostate gland, or the presence of anti-sperm antibodies that clot and immobilize the sperm, rendering them ineffective. Either of these can contribute to difficulty conceiving a pregnancy.

Blood Tests

These tests may include determination of blood levels for estrogen, progesterone, prolactin, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) at various points of the menstrual cycle. Abnormalities in these hormones can explain lack of regular, predictable ovulation. Additionally, testing for specific immune system markers may be done, since couples who share certain of these markers have a greater tendency to be infertile; the reasons for this association are unclear.

X-ray Studies

In the hysterosalpingogram, an oil-based dye, visible on X-ray, is instilled into the uterus and fallopian tubes within three days after the menstrual period. The dye will fill the cavities and tubes, outlining the architecture of these structures. Polyps, partitions, benign tumors and obstructions will all be visible on the X-ray. If the dye is seen to disperse widely within the abdominal cavity, the fallopian tubes are said to be patent (open).

Laparoscopic surgery

If infertility persists despite a normal initial evaluation, looking at the uterus, tubes and ovaries with the laparoscope (a fiberoptic telescope inserted into the abdomen) may detect contributing causes to infertility in as many as one in four women; conditions commonly discovered include polycystic ovarian syndrome, scarring in and around the fallopian tubes or pockets of stray uterine lining tissue (endometriosis).

Last Updated: 10/31/2002
The Johns Hopkins University 1996-2003.  All rights reserved.  This information is not intended to provide advice on personal medical matters, nor is it intended to be a substitute for consultation.