A hysterosalpingogram (HSG) is an x-ray exam. The test is designed to look for signs of physical problems that might make conception difficult for a woman. The procedure includes using a catheter to inject iodine into the uterine cavity to create a contrast for the x-ray. For example, a specialist will look for any abnormalities in the shape of the uterine cavity or if the fallopian tubes are open. Any problems in either location may make conception difficult as the egg may struggle to travel down the fallopian tubes, or an embryo may not be able to implant properly.
Ovarian reserve testing
Most people are aware that women are born with all the eggs available in the ovaries. But as women age, the quality and availability of the eggs can decline. An ovarian reserve test is a diagnostic procedure used to determine a woman’s egg quality and quantity. The most common form of the test is performed by drawing blood and looking for follicle-stimulating hormone (FSH). The test tends to be prioritized in women who are considered high-risk, such as age 35 or older, poor hormonal balance, a family history of early menopause or a history of ovarian surgery or cancer treatment that might cause infertility.
A transvaginal ultrasound
Similar to the hysterosalpingograms, a transvaginal ultrasound may also be performed to look for physical abnormalities that might impede conception. Rather than injecting a solution, an ultrasound probe is inserted in the vagina so that a clinician can check both the uterus and ovaries for any signs of physical damage like fibroids or ovarian cysts. Transvaginal ultrasounds can also be used as effective diagnostics in additional tests such as the sonohysterography that relies on the ultrasound after filling the uterus with saline to improve visual detection results.
Ovulation testing is one of the few at-home fertility diagnostics that women can use independently. Many over-the-counter (OTC) tests rely on detecting luteinizing hormone (LH) in the urine. LH is a hormone that usually spikes just before ovulation. However, some women may also undergo blood tests to check for progesterone, a hormone that the body produces after ovulation.
In some cases, a specialist may prescribe laparoscopic surgery. The procedure is considered minimally invasive and requires making a small incision beneath the navel before inserting a thin visual probe to examine the ovaries, fallopian tubes, and uterus. The doctor may also insert the probe through the patient’s vagina. The diagnostic is useful for identifying conditions that can make conception difficult such as endometriosis, fallopian tube scarring or blockages, and other issues with the ovaries or uterus.
A comprehensive approach to female fertility
Just like with men, fertility testing in women can be comprehensive and isn’t solely limited to one test. Many underlying issues can contribute to a difficulty to conceive, from physical abnormalities to hormonal imbalances that might interfere with ovulation. Women concerned about infertility should speak to a fertility specialist to schedule testing.