Diagnosing Infertility

The National Institute of Clinical Excellence (NICE) defines infertility as: The inability to conceive within two years of regular intercourse without the use of contraceptives. In practice, most couples should seek medical help after one year. Couples with a complex problem or increasing age may need to seek assistance sooner than this. Fertility Tests The fertility tests that you will require depend on the complexity of your problem. Some common tests for diagnosis are:

�	Blood Tests: Hormone Level Check Follicle Stimulating Hormone (FSH) and Luteinising Hormone (LH) levels are measured at the beginning of your cycle to give an indication of the supply and quality of the eggs that are developing in your ovaries. Progesterone is measured on day 21 of a 28 day cycle to assess whether you are ovulating normally. Prolactin, Oestrogen and Thyroid hormone levels may also be measured. If a woman's thyroid gland is underactive it can interfere with the ovulatory function and quality of eggs that she releases.
�	Ultrasound Scans: Assesses the health of your ovaries, uterus, follicles developing and may exclude any gynaecological abnormalities.
�	Hysterosalpingogram (HSG):  Similar to an x-ray to check whether the cavity of your uterus is normal and whether your Fallopian tubes are open.
�	Laparoscopy: A careful inspection of  your ovaries, uterus and Fallopian tubes using a small telescopic device which will detect and give opportunity to treat any problems detected
�	Hysteroscopy: A direct examination of the interior of your uterus with a viewing instrument. This allows any adhesions or polyps to be seen and, if necessary, removed.
�	Semen Analysis: Assessment of sperm count, motility and morphology (shape) carried out on fresh semen. What the Tests may Show The most common causes of infertility in women are ovulation failure and blockage or damage of the Fallopian tubes. Endometriosis and cervical mucus disorders are less frequent causes. In men, poor sperm function or a very low sperm count is more common than a complete failure of sperm production. The results of the investigations for some couples will be negative or normal and this situation is called "unexplained" infertility. Couples with unexplained infertility who have been trying for a pregnancy for more than two years, or where the woman is over 35 years of age, need to consider fertility treatment to help them conceive.