Female Fertility Diagnosis and Testing

An egg is thrown from the ovary into the tube each month, so called ovulation. Without ovulation, there is no conception. Regular monthly menstrual cycles equate with ovulation. Polycystic Ovarian Syndrome, Hypothalamic Anovulation, Luteal Phase Insufficiency and problems with other hormones such as thyroid hormone or Prolactin may interfere with ovulation. Most women will ovulate well into their 40's and even 50's but it is the quality of the eggs being ovulated that is critical. Young women that do not ovulate regularly can usually be induced to ovulate with either oral or injectable medications.

Ovarian Reserve

This is the concept of what is a woman's reproductive potential and what are the chances that a woman will be able to conceive a healthy, viable pregnancy with her own eggs? We test for ovarian reserve with blood tests (cycle day 3 FSH and AMH levels and vaginal ultrasound to check ovarian reserve). There are some other tests such as thyroid, prolactin and androgens to assess the hormonal status of the women.

Tubal Status

Infection, post-surgical scarring or the disease endometriosis can cause fallopian tubes to be blocked, kinked or distorted. This prevents eggs and sperm from getting together and can lead to tubal (ectopic) pregnancy. The dye test HSG (hysterosalpingogram) is the only non-surgical way to evaluate the patency of the fallopian tubes that is to determine whether or not the tubes
are open.

Uterus and Endometrial Lining

Fibroids, polyps, intrauterine scarring from prior surgery are some of the things that can cause the uterus and its lining to be abnormal and to cause an embryo to fail to implant. Vaginal ultrasonography performed just prior to ovulation can often be sufficient to diagnose
any problem.


Some patients carry genetic diseases or abnormal chromosoms that can cause infertility or repeated miscarriage. These problems are rare but need to be evaluated before the treatment.


This is one example of a disease of the female reproductive years that is strongly associated with infertility. Surgery is the only way to make a definitive diagnosis. Surgery may be helpful in improving the chance of conception.

Hormonal Blood Tests

FSH and LH: This blood test should be done during day 2 to day 5 of your cycle. FSH, LH levels are important to know your ovarian function. Day 1 is first full day of your period. Blood levels after 5th day can give us wrong information.

TSH: To know your thyroid hormonal levels. Thyroid hormone can sometimes disturb the menstrual cycle and thereby affect fertility.

Prolactin: High levels of prolactin is known to be associated with problems with ovulation.

Infection screen


Saline Infused Sonography (SIS)