BBT charting. If you haven't already been doing it, your doctor may recommend that you begin charting your basal body temperature as a way of checking ovulation. However, while BBT charting is a technique that has been used for ages, experts don't believe that it is as accurate as other ovulation tests.
Postcoital test. This test requires that you have intercourse several hours in advance and then visit your doctor to have a sample of cervical mucus taken for microscopic examination. It's a way of testing both the viability of the sperm and their interaction with the cervical mucus.
Transvaginal (pelvic) ultrasound exam. Your doctor might recommend an ultrasound to check the condition of the uterus and ovaries. Often the doctor can determine whether the follicles in the ovaries are working normally. Thus, the ultrasound is often performed 15 days before a woman's expected menstrual period.
Hysterosalpinogram. Your doctor may also suggest a hysterosalpinogram, also known as an HSG or "tubogram." In this procedure, a series of X-rays is taken of your fallopian tubes after a liquid dye has been injected into your uterus through your cervix and vagina. The HSG can help diagnose fallopian tube blockages and defects of the uterus. If one of the tubes is blocked, the obstruction should be apparent on the X-ray since the liquid dye won't get past it. An HSG is usually scheduled between days six and 13 of your cycle.
Hysteroscopy. If a problem is found in the HSG, your doctor might order a hysteroscopy. In this procedure, a thin teloscope-like instrument is inserted through the cervix into the uterus to allow the doctor to see and photograph the area to look for problems.
Laparoscopy. After the above tests have been done, your doctor may want to do a laparoscopy. In this, a laparoscope is inserted into the abdomen through a small incision to look for endometriosis, scarring, and other conditions. This procedure is a little more invasive than an HSG and requires that you go under general anesthesia.
Endometrial biopsy. Your doctor may want to take a biopsy of your uterine lining to see if it's normal, so an embryo could implant in it. During an endometrial biopsy, a doctor removes a sample of tissue from the endometrium with a cathether that is inserted into the uterus through the vagina and cervix. The sample is analyzed in the lab. The procedure is somewhat uncomfortable; therefore, a painkiller is given beforehand.
Not all women undergo all these tests. Your doctor will guide you through those that are most appropriate for your situation. After the testing is done, about 85% of couples will have some idea why they're having trouble getting pregnant.
SOURCES: American Society for Reproductive Medicine web site. Aerican College of Obstetricians and Gynecologists web site. WebMD Fertility Center web site. Human Reproduction Update, July-August 2002. The Infertility Workup and Understanding Treatment Options, RESOLVE online. The Merck Manual, Seventeenth Edition, 2000. The Fertility Handbook: A Guide to Getting Pregnant, Addicus Books, 2002. U.S. Dept. of Health and Human Services, Endometriosis, September 2002.
Good to Know is a new feature that allows members of the community to answer questions from WebMD experts, doctors, staff, and other community members. We're testing this new feature and we'd like your feedback.
Pregnancy Week-By-Week Newsletter
Delivered right to your inbox, get pictures and facts on what to expect each week of your pregnancy.