Most tests used to detect fertility in the woman check if and when ovulation has occurred. Other tests check for any structural abnormalities in her reproductive system.
A way to predict ovulation is by using a urine test kit at home. This test measures luteinizing hormone (LH), which is released by the pituitary gland to cause ovulation. If the test is positive, it indicates that ovulation is about to occur. Sometimes these kits are used to supplement basal body temperature charts.
After a woman ovulates, there is a rise in body temperature-as much as 1°F- that can happen suddenly in one day or slowly over several days. To record her basal body temperature, a woman takes her oral temperature every morning before she gets out of bed and records it on a sheet of graph paper. This record usually has to be kept for 2-3 months. This test may suggest whether ovulation has occurred and whether it occurs on a regular basis. It may be helpful in planning the timing of other tests.
After a woman ovulates, the ovaries produce progesterone, a hormone that prepares the lining of the uterus to nourish a fertilized egg. A blood test, taken 5-10 days before a woman's period is due, can be used to test for ovulation by measuring progesterone.
Sometimes this test is performed to find out whether and when ovulation has occurred and whether there are problems with how the lining of the uterus responds to ovulation. The procedure is done a few days before a woman's period is due. A thin, hollow tube is inserted into the vagina and through the cervix to remove a small piece of the uterine lining. This sample is later examined under a microscope. This procedure is done in the doctor's office.
The postcoital (after sex) test examines the ability of sperm to enter and move into the cervical mucus just before the time of ovulation. The couple has intercourse close to the time of ovulation, and the cervical mucus is examined a few hours later. A PCT can also show if there is a reaction between the sperm and cervical mucus that could be causing infertility.
This test is an X-ray that examines the inside of the uterus and fallopian tubes. It is usually performed right after the menstrual period in a radiologist's office or the X-ray department of a hospital.
A small amount of fluid is placed in the uterus through a thin tube inserted through the cervix, and an X-ray is taken. The fluid outlines the inside of the uterus and shows (by a spill of the fluid out of the tubes) whether they are open.
Ultrasound uses sound waves to produce images of internal structures. This test can check the ovaries and uterus, as well as the thickness of the uterine lining. It can also be used to show the development of the egg in the ovary.
For this procedure, the doctor places a telescope-like instrument, called a hysteroscope, through the cervix. The inside of the uterus may be filled with a gas or liquid. With the hysteroscope, the doctor can see the contents of the uterine cavity, including the opening of the tubes on the inside of the uterus. During this procedure, the doctor can correct minor problems, get a biopsy sample, or determine whether another operation is needed. Hysteroscopy is performed under local or general anesthesia.
A light-transmitting, telescope-like instrument, called a laparoscope, is inserted through a small incision (about ½ inch or less) at the lower edge of the navel. The abdominal cavity is filled with gas so the uterus can be seen. With this procedure, the doctor can look for pelvic disease, such as endometriosis, that may interfere with conception. The fallopian tubes can also be examined and tested to determine whether they are open by injecting a fluid into the uterus and tubes. It usually is performed under general anesthesia and does not require an overnight hospital stay.
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