Fertility Treatment

Fertility treatments often include medications that help with hormones and ovulation, sometimes combined with minor surgical procedures. Assisted Reproductive Technology (ART) describes several kinds of procedures that can help you have a baby. ART includes procedures that make it easier for sperm to fertilize an egg, and help the egg implant in your uterine lining.

Two of the most common fertility treatments are:

intrauterine insemination (IUI)
- Healthy sperm is collected and inserted directly into your uterus when you’re ovulating.
in vitro fertilization (IVF)
- Eggs are taken from your ovaries and fertilized by sperm in a lab, where they develop into embryos. Then a doctor puts the embryos into your uterus.

Tests for men

Male fertility relies on the testicles making enough healthy sperm. The sperm needs to be released from the penis into the vagina, where it has to travel to the waiting egg. Tests for male infertility try to find out whether there are treatable problems with any of these steps.

You may have a physical exam that includes a check of your genitals. Specific infertility tests may include:

Semen analysis. Your health care team may ask for one or more samples of your semen. Often, you collect semen by masturbating or by stopping sex to ejaculate into a clean container. Then a lab checks your semen sample. In some cases, urine may be tested to find out if it contains sperm.
Hormone testing. You may get a blood test to check your level of testosterone and other male hormones.
Genetic testing. This may be done to find out whether a genetic defect is the cause of infertility.
Testicular biopsy.This procedure removes a small amount of testicle tissue so a lab can check it under a microscope. It’s not common to need a biopsy during infertility testing. Rarely, it may be done to find out whether there is a blockage in the reproductive tract that keeps sperm from leaving the body in semen. Most of the time, this diagnosis can be made based on your history, physical exam and lab tests. Other times, a biopsy may be done to find conditions that contribute to infertility. Or it may be used to collect sperm for assisted reproductive techniques, such as in vitro fertilization (IVF).
Imaging. In some cases, your health care team may recommend tests that make pictures of the inside of your body. For example, ultrasound can check for problems in the scrotum, in the glands that make fluids that become semen or in the tube that carries sperm out of the testicles. A brain MRI can check for tumors of the pituitary gland that are not cancer. These tumors can cause the gland to make too much of the hormone prolactin, which could lead the body to make less sperm or none.
Other testing. In rare cases, other tests may be done to check the quality of your sperm. For example, a semen sample may need to be checked for problems with DNA that might damage sperm.

Tests for women

Fertility for women relies on the ovaries releasing healthy eggs. The reproductive tract must let an egg pass into the fallopian tubes and join with sperm. Then the fertilized egg must travel to the uterus and attach to the lining. Tests for female infertility try to find problems with any of those steps.

You may have a physical exam, including a regular pelvic exam. Infertility tests may include:

Ovulation testing. A blood test measures hormone levels to find out whether you’re ovulating.
Thyroid function test. This blood test can be done if your health care team thinks your infertility might be related to a problem with the thyroid gland. If the gland makes too much or little thyroid hormone, that could play a role in fertility trouble.
Hysterosalpingography. Hysterosalpingography (his-tur-o-sal-ping-GOG-ruh-fee) checks on the condition of the uterus and fallopian tubes. It also looks for blockages in the fallopian tubes or other problems. Special dye is injected into the uterus, and an X-ray is taken.
Ovarian reserve testing. This helps your care team find out how many eggs you have for ovulation. The method often begins with hormone testing early in the menstrual cycle.
Other hormone tests. These check the levels of hormones that control ovulation. They also check pituitary hormones that control processes involved in having a baby.
Imaging tests. Pelvic ultrasound looks for diseases of the uterus or ovaries. Sometimes a test called a saline infusion sonogram is used to see details inside the uterus that can’t be seen on a regular ultrasound. Another name for the saline infusion test is a sonohysterogram (son-o-his-ter-OH-gram).

Rarely, testing may include:

Hysteroscopy. Depending on your symptoms, your health care team may use a hysteroscopy (his-ter-os-ko-pee) to look for a disease of the uterus. During the procedure, a thin, lighted device is placed through the cervix into the uterus to check for any irregular signs. It also can help guide minor surgery.
Laparoscopy. Laparoscopy (lap-u-ros-kuh-pee) involves a small cut beneath the navel. Then a thin viewing device is placed through the cut to check the fallopian tubes, ovaries and uterus. The procedure may find endometriosis, scarring, blockages or other issues with the fallopian tubes. It also might find treatable problems with the ovaries and uterus. Laparoscopy is a type of surgery that can treat certain conditions as well. For example, it can be used to remove growths called fibroids or endometriosis tissue.

Not everyone needs to have all, or even many, of these tests before the cause of infertility is found. You and your health care team decide which tests you will have and when.