Tests to Assess Fertility in Women

Numerous factors can affect fertility in women. It is, however, important to undergo a medical evaluation to know the root cause of infertility. Every 1 in 6 couples in Canada is affected by infertility and in majority cases, it can be treated with simple medical interventions – counseling, medications, IUI or IVF.

When should you consider opting for an infertility evaluation?

You should consider consulting a reproduction endocrinologist or an obstetrician-gynecologist for an infertility evaluation if any of the following apply to you:

  • You have not become pregnant after 1 year of regular unprotected sexual intercourse, without the use of birth control.
  • You are older than 35 yrs of age and have not become pregnant after having sex without contraceptive use for 6 months.
  • You are older than 40 yrs of age and have not become pregnant after having sex without contraceptive use for 6 months.
  • Your menstrual cycles are not regular
  • You or your partner have a known fertility issue (due to an injury, trauma or medical issue)

What are the major causes of Infertility in Women?

The most common cause of female infertility is the lack of or irregular ovulation. The other common causes include:

  • Hormonal imbalances
  • Changes associated with increasing age
  • Endometriosis
  • Obesity and Insulin Resistance
  • Scarring or blockages in the fallopian tubes due to endometriosis or past sexually transmitted infections
  • Issues with the Thyroid or Pituitary gland
  • Pre-existing medical conditions

CReATe Fertility London Infertility Assessment for Women:

CReATe Fertility London has a well-detailed plan to diagnose your infertility issues. During your consultation, your doctor will assess your medical history including:

  • Menstrual history including signs of ovulation
  • Sexual history
  • History of previous pregnancy or pregnancy loss
  • Risk factors for tubal disease or endometriosis
  • Signs of hormonal imbalances
  • Any surgical or medical history, medications

An assessment of your previous reports and past treatments is essential; if you have previous medical reports, please bring them to your first visit.

Your infertility assessment is further divided into three parameters:

1. Tests for Hormonal Evaluation:

Hormone levels are evaluated through simple blood tests. Hormones are key in fertility and an important part of the female reproductive cycle. Any fluctuations or imbalance can cause infertility and other medical conditions. Your doctor may order assessment for Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH), Estradiol, Progesterone, Prolactin, thyroid test, Total Testosterone, Free Testosterone, or DHEA-S, to list a few.

2. Tests for Ovulation:

This is done via transvaginal sonography, generally starting from day 3 of the menstrual cycle. This checks for growth and rupture of the follicle (egg). The patient will be advised timed intercourse depending on the day of her ovulation. If required, medication will be advised to induce ovulation.

3. Tests for Reproductive Organs (Tubal Status and Uterine Cavity):

These tests include an assessment of your fallopian tubes, uterus and ovaries, which are all vital for a normal pregnancy.

  • Sonohysterogram
    Also known as the Sono-HSG, this test includes a fluid-filled ultrasound of your fallopian tubes and uterus. The Sono-HSG helps to detect any fallopian tube blockages or defects in the uterus. This test is done after your menstrual cycle. During the procedure, a small amount of saline is inserted into the uterine cavity, which lets your doctor see the structure of the uterus using a transvaginal ultrasound. The sonohysterography is done after a menstrual cycle has finished, but prior to ovulation. For most women, this is between days 5 to 11 of the menstrual cycle.
  • Ultrasound
    This non-invasive test is to detect any abnormalities in the ovaries and the uterus through detailed ultrasound images. An ultrasound will be used all through your fertility journey to check the structure of the uterus and ovaries, monitor the ovaries and check the thickness of the uterine wall and endometrial lining, to assess any physical abnormalities that can interfere with pregnancy, to confirm or assess the progress of the pregnancy.
  • Hysteroscopy
    This is a surgical scoping procedure to check the uterine cavity and assess any factors causing infertility. This procedure is performed under mild sedation, with the help of a flexible tube enabled with a camera on the end. The tube is inserted through the cervix into the uterus to check for polyps, fibroids, scar tissue or septum. Treatment, repair or sample collection for further analysis can also be done at the same time. If there is a large fibroid in the uterus, then your doctor may recommend a hospital hysteroscopy or a laparoscopy procedure in the hospital.
  • Laparoscopy
    This is a minimally invasive day surgery performed at a hospital under general anesthesia. This procedure is minimally invasive and is carried out through 2-3 tiny incisions in your abdomen or through the belly button. Your doctor can diagnose and treat conditions that could be affecting your fertility such as endometriosis and scar tissue. In addition, the fallopian tubes can be assessed for blockages.

Based your test results, your doctor will recommend the best procedure for assisted reproduction.