In addition to menstrual history, other ovulation evaluation methods include tests that assess levels of hormones that trigger successful ovulation and uterine preparation for pregnancy, urinary luteinizing hormone (LH) ovulation predictor kits, mid-luteal serum progesterone testing, endometrial biopsy, and basal body temperature recordings.

Assessment of Ovarian Reserve

Women over 35 or a history of prior ovarian surgery may be at risk for diminished ovarian function or reserve (fewer healthy eggs due to natural aging). Ovarian reserve tests assess serum follicle-stimulating hormone (FSH) and estradiol levels, clomiphene citrate challenge, or an ovarian antral follicle count (the reserve of eggs in ovaries that are candidates for selection and growth by fertility stimulation medications).

The results of these tests are not absolute indicators of infertility but abnormal levels correlate with decreased response to ovulation induction medications and lowered IVF success.

Assessment of Uterus and Fallopian Tubes

Assessment of the uterine contour and tubal health is an integral part of the basic infertility evaluation. This may include an hysterosalpingography (HSG), a X-ray of the uterine cavity and fallopian tubes following injection of a radio-opaque medium. Ultrasound may be used to identify uterine fibroids, polyps, congenital anomalies, information on ovarian volume and follicle counts.

When Is A Laparoscopy Used for Infertility Evaluation?

Laparoscopy is a minimally invasive surgical procedure that uses a small camera that allows direct visual examination of the pelvic reproductive anatomy, such as the outside of the uterus, ovaries and fallopian tubes. It is performed in women with unexplained infertility or signs of reversible tubal disease.