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1Testing at Home
2Getting Routine Fertility Testing
3Undergoing Additional Tests
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Co-authored byAimee Eyvazzadeh, MD, MA
Last Updated: September 15, 2021References
Testing female fertility can be a complex process. If you’re hoping to use fertility tests to achieve pregnancy more quickly, you might start by using at home tests, such as basal body temperature charting and ovulation prediction tests. However, if you’ve been trying to conceive for a while and have concerns about your fertility, it’s best to see a doctor for testing. They can use a combination of blood and imaging tests to identify and treat potential fertility problems.
Method 1
Method 1 of 3:
Testing at Home
1
Track your cycle with a calendar or app if you don’t already. Mark when your period starts and ends as well as any other pertinent information on the calendar, such as your basal body temperature or the consistency of your cervical mucus. This will help you to determine the best days to take an ovulation test and know when it is more likely that you will be fertile.[1]
- You can keep track of your cycle using a physical calendar or an app on your phone. There are also websites that provide free fertility trackers you can use.
- Ovulation typically happens about 14 days before your period starts. If your periods are regular, you can use the date when your period starts to help you estimate when you’ll ovulate the next month.
2
Take your basal body temperature to detect your fertile window. Take your temperature first thing in the morning before you even get out of bed and record it. Do this every day for your entire cycle to detect a pattern. Your temperature will rise by about 0.4–1°F (−17.6– −17.2°C) when you ovulate and remain at about this level to the end of your cycle.[2]
- Some women also notice a temperature dip about mid-cycle, which usually indicates that you are about to ovulate.
- For most women, the temperature change takes place 1-2 days after the hormone surge that marks the start of ovulation, and lasts for up to 10 days. It can be helpful for looking back and determining when your ovulation window took place, but it isn’t especially useful for deciding when to have intercourse.
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3
Use over-the-counter ovulation test strips to predict ovulation. This test can help you to conceive by detecting your luteinizing hormone surge. When you get a positive result, you may ovulate within 24 to 48 hours, so this is a good time to have intercourse. You can either urinate onto the strip or urinate into a cup and dip the strip into the urine to test it. Then, read the results in about 5 minutes.[3]
See AlsoBest At-Home Fertility Tests in 2024Fertility Tests for Women: A Comprehensive OverviewHow Can Women Check Their Fertility? A Guide to Fertility TestsWant to Know Why You're Having Trouble Getting Pregnant? This Test Can Offer Clues- Test strips are easy to find in drug stores and online.
4
Try a ferning saliva test to detect ovulation with a microscope. If you’re comfortable using a microscope, you could try doing saliva ferning tests to check when you might be ovulating. This involves taking a swab of your saliva towards the middle of your cycle (days 10-18) and placing it on a glass slide. Then, you look at the slide under a microscope to check for a ferning pattern, which will resemble the leaves of a fern plant. If your saliva ferns, then you may be ovulating.[4]
- Take the test first thing in the morning before you eat, drink, or brush your teeth for best results.
Tip: Keep in mind that not all women get a ferning pattern to their saliva and the test can also be affected by many factors, such as eating, drinking, and brushing your teeth.
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Method 2
Method 2 of 3:
Getting Routine Fertility Testing
1
See your obstetrician-gynecologist for an initial assessment. If you’ve been trying to conceive for more than 1 year or if you’re over 35 and you have been trying to conceive for more than 6 months without success, then you may benefit from a medical evaluation. Your OB-GYN can perform an initial evaluation to identify problems that may prevent pregnancy, such as lifestyle factors, pre-existing medical conditions, or hormonal imbalances.[5]
- For example, your doctor may advise you to avoid drinking alcohol while trying to conceive as this may have a negative impact on your fertility.
- Or, your doctor may want to re-check your thyroid levels and adjust your medication if you take thyroid hormone for hypothyroidism.
2
Make an appointment with a reproductive endocrinologist for more testing. If your OB-GYN is unable to diagnose or treat the cause of your infertility, they may advise you to see a reproductive endocrinologist for further evaluation. This is a doctor who specializes in treating infertility. They can perform a wider range of tests and offer more treatment options than an OB-GYN.[6]
- A reproductive endocrinologist also has more experience with infertility, so they may be much more adept at diagnosing and treating the problem.
3
Go for bloodwork to check for hormonal imbalances. One of the first things your OB-GYN or reproductive endocrinologist may do is order bloodwork to check for common hormonal issues that can prevent pregnancy. If a problem is detected, your doctor may be able to treat it with medication. These may check the levels of your:[7]
- Luteinizing hormone
- Follicle stimulating hormone
- Estradiol
- Progesterone
- Prolactin
- Free T3[8]
- Testosterone, especially your doctor suspects you have PCOS
4
Get an ultrasound to check the thickness of your endometrium. If your endometrium is not thick enough, the egg will not be able to implant in it. This is necessary for a healthy pregnancy, so your doctor may order an ultrasound as an early imaging test. Ultrasounds are non-invasive, painless, and quick to perform.[9]
- You may feel some temporary discomfort from the probe since it may need to be inserted vaginally to get the required images.
5
Have a post-coital cervical mucus test to check on sperm. For this test, you and your partner will have intercourse and then you will go to your doctor’s office for a test similar to a pap smear. The doctor will take a sample of your cervical mucus from inside of your vaginal canal and look at it under a microscope to see if the sperm are still alive and moving around.[10]
- Your doctor may order this test to check how sperm are faring in your cervical mucus after intercourse.
6
Undergo a Hysterosalpingogram to check internal structures. For this imaging test, your doctor will use a catheter to inject a contrast dye into your cervix. After the dye passes into your uterus, the doctor will take X-ray images. The dye goes all the way through your fallopian tubes if they are open, and if it does not, then this may indicate a blockage.[11]
- Your doctor will most likely order this test within the first 14 days of your menstrual cycle since it cannot be performed if you are pregnant.
- The test is uncomfortable and you may experience a strong cramping sensation until the test is over. However, it’s a very quick test, and the cramping should subside immediately after it’s over.[12]
- You may be instructed to take an over-the-counter pain reliever about 1 hour prior to the test. Some doctors also prescribe an antibiotic to reduce the risk of infection.[13]
- Anesthesia is not required for this test, but some people feel unwell after having it done, so it’s best to have someone drive you home.
Tip: Take a few deep breaths right before the doctor injects the dye into your cervix and try to breathe normally during the test.
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Method 3
Method 3 of 3:
Undergoing Additional Tests
1
See Also3 Ways to Test Female FertilityGet a hysteroscopy if the HSG shows a potential abnormality. A hysteroscopy involves inserting a small camera into your cervix to take images of the inside of your uterus. This test may be required to confirm an issue indicated by an HSG. Your doctor will likely schedule this test for the week after your period to get the best possible images.[14]
- This procedure can be done as an in-office procedure or it may be done as part of an operative procedure, such as to remove polyps or adhesions (scar tissue).
2
Look into laparoscopy to detect and correct issues. Diagnostic laparoscopy is a surgical procedure that allows your doctor to see inside of your uterus using a small fiberoptic camera that’s inserted through your abdomen. Using this technique, your doctor can correct any abnormalities they find, such as endometriosis or scar tissue. This procedure is performed under general anesthesia.[15]
- Your doctor will likely order a blood test before the procedure to ensure that you are not pregnant.
- Even if your hysterosalpingogram was normal, your doctor may order a diagnostic laparoscopy to check for issues that may be impacting your fertility.[16]
- Laparoscopy is a full surgical procedure that is performed under general anesthesia. Your doctor is unlikely to recommend it except as a last resort to rule out endometriosis.
3
Request ovarian reserve testing if you’re over 35. This test may be helpful for women older than 35, which is when egg supply begins to decline. It can help to predict whether or not assistive reproductive techniques may be successful.[17] Ask your doctor about this option if you are over 35 and have concerns about egg depletion.[18]
- This test involves a few different hormone blood tests, some of which may be part of your normal bloodwork panel, and an ultrasound of your ovaries.
- No one fertility test is reliable by itself. It’s important to combine multiple tests to get the best assessment of your fertility. Ask your doctor about testing your ovarian reserve with your AMH, day 3 follicle-stimulating hormone (FSH), and estradiol levels.
4
Seek genetic tests to check for underlying issues. While it’s less common, there are some genetic conditions that can affect a woman’s fertility.[19] If you’ve had multiple miscarriages, a known family history of a genetic condition, or multiple failed IVF transfers, then undergoing genetic testing may be a good option to find out what’s causing this.[20]
Tip: Your partner will likely need to undergo genetic testing as well since there are some conditions that can affect men.[21]
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Expert Q&A
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Question
How do ovulation tests work?
Aimee Eyvazzadeh, MD, MA
OB/GYN & Fertility SpecialistAimee Eyvazzadeh is a Fertility Specialist and the Founder of The Egg Whisperer Show, a fertility care program focusing on fertility education based in the San Francisco Bay Area. Her work has been featured in magazines such as People, Forbes, and Marie Claire, and she has been featured on the Today Show, Good Morning America, and CNN. She earned an MD from the University of California, Los Angeles in 2001, completed an OB/GYN residency at Harvard Medical School in 2005, and finished a fellowship in Reproductive Endocrinology and Infertility at University of Michigan, where she also completed an MPH.
Aimee Eyvazzadeh, MD, MA
OB/GYN & Fertility Specialist
Expert Answer
The goal with ovulation predictor kits isn't to see a positive test; it's to see a trend toward positive. If you don't see a 'peak,' it doesn't mean you didn't ovulate—it just means the test wasn't sensitive enough to pick it up.
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References
- ↑ https://americanpregnancy.org/getting-pregnant/female-fertility-testing/
- ↑ https://www.acog.org/Patients/FAQs/Evaluating-Infertility?IsMobileSet=false
- ↑ https://www.fda.gov/medical-devices/home-use-tests/ovulation-urine-test
- ↑ https://www.fda.gov/medical-devices/home-use-tests/ovulation-saliva-test
- ↑ https://www.acog.org/Patients/FAQs/Evaluating-Infertility?IsMobileSet=false
- ↑ https://www.mayoclinic.org/diseases-conditions/female-infertility/diagnosis-treatment/drc-20354313
- ↑ https://www.mayoclinic.org/diseases-conditions/female-infertility/diagnosis-treatment/drc-20354313
- ↑ https://americanpregnancy.org/getting-pregnant/female-fertility-testing/
- ↑ https://americanpregnancy.org/getting-pregnant/female-fertility-testing/
More References (12)
- ↑ https://americanpregnancy.org/getting-pregnant/female-fertility-testing/
- ↑ https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/multimedia/hysterosalpingography/img-20005963
- ↑ https://www.mayoclinic.org/diseases-conditions/female-infertility/diagnosis-treatment/drc-20354313
- ↑ https://www.acog.org/Patients/FAQs/Hysterosalpingography?IsMobileSet=false
- ↑ https://my.clevelandclinic.org/health/treatments/10142-hysteroscopy
- ↑ https://americanpregnancy.org/getting-pregnant/female-fertility-testing/
- ↑ https://www.ncbi.nlm.nih.gov/pubmed/19713683
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3276943/
- ↑ https://www.mayoclinic.org/diseases-conditions/female-infertility/diagnosis-treatment/drc-20354313
- ↑ https://www.mayoclinic.org/diseases-conditions/female-infertility/diagnosis-treatment/drc-20354313
- ↑ https://resolve.org/what-are-my-options/genetic-screening-and-testing/
- ↑ https://www.sciencedirect.com/science/article/pii/S111056901000052X
About this article
Co-authored by:
Aimee Eyvazzadeh, MD, MA
OB/GYN & Fertility Specialist
This article was co-authored by Aimee Eyvazzadeh, MD, MA. Aimee Eyvazzadeh is a Fertility Specialist and the Founder of The Egg Whisperer Show, a fertility care program focusing on fertility education based in the San Francisco Bay Area. Her work has been featured in magazines such as People, Forbes, and Marie Claire, and she has been featured on the Today Show, Good Morning America, and CNN. She earned an MD from the University of California, Los Angeles in 2001, completed an OB/GYN residency at Harvard Medical School in 2005, and finished a fellowship in Reproductive Endocrinology and Infertility at University of Michigan, where she also completed an MPH. This article has been viewed 3,288 times.
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Co-authors: 8
Updated: September 15, 2021
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