When It's Hard to Get Pregnant

Fertility tests that you need—and those you don’t

If you and your partner have not been able to have a baby, talk to your gynecologist or a fertility specialist. Usually both you and your partner will need some tests. Many of the tests are helpful.

But some tests are not needed.

Your doctor should ask you and your partner about your health and sexual histories. Then, you will probably have several of the following tests.

Tests that women often need:

  • Blood test to check the number and quality of eggs in the ovaries. Women who are over age 35 may especially need this test.
  • An X-ray called hysterosalpingogram (HSG). This test shows if your fallopian tubes are damaged or blocked.
  • An ultrasound. This test uses sound waves to check the uterus and ovaries for problems that could prevent pregnancy.

A test that men often need:

Men usually need to give a semen sample so doctors can check the number and quality of the sperm.

Tests that usually aren’t needed.

Most couples don’t need these tests:

  • Laparoscopy
  • Post-coital test

Laparoscopy

This is a surgical procedure. The doctor puts a thin, lighted telescope through a small cut in a woman’s belly. The doctor examines the pelvic area through the telescope, looking for problems that can cause infertility. Doctors can correct many of these problems, such as blocked fallopian tubes, scar tissue, and endometriosis.

Laparoscopy has risks.

  • You need general anesthesia.
  • There may be complications such as infection, scar tissue, and bruising.
  • Less often, an organ or blood vessel is damaged, and further surgery is needed.

You might need laparoscopy if: Your history and other tests suggest that you have a problem, such as:

  • An abnormal HSG, ultrasound, or pelvic exam.
  • You’ve had pelvic pain, appendicitis, or previous surgery in the pelvis. Or you have a history of pelvic infections, such as gonorrhea or chlamydia.

Post-coital test (PCT)

For this test, a woman goes to the doctor right after having intercourse. The doctor takes mucus from her cervix and checks for moving sperm.

PCT has risks.

  • It usually does not provide helpful information and it leads to further testing. Studies show that the results found with PCT do not help women get pregnant.
  • For some couples, having sex on a schedule adds to their stress.

You might need PCT if: The male partner refuses to provide semen for testing due to religious or personal beliefs.

This report is for you to use when talking with your health-care provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2015 Consumer Reports. Developed in cooperation with the American Society for Reproductive Medicine for Choosing Wisely, a project of the ABIM Foundation. To learn more about the sources used in this report and terms and conditions of use, please visit ConsumerHealthChoices.org/about-us/.

12/2015