Infertility Diagnosis and Tests

Infertility is defined as the inability to achieve pregnancy within one year despite regular, unprotected sexual intercourse. In women over the age of 35, this period is considered to be six months. Infertility may be caused by female factors, male factors, both partners, or, in some cases, unexplained reasons. Therefore, an accurate diagnostic and testing process is of great importance for treatment success.

Infertility diagnosis and testing involve a systematic, individualized approach that evaluates both partners together. With early and accurate diagnosis, unnecessary time loss can be prevented and the most appropriate treatment method can be determined.

How Is Infertility Diagnosed?

The diagnosis of infertility is made through a detailed medical history and comprehensive evaluation. In the first stage, the duration of the couple’s attempts to conceive, any previous pregnancies, past illnesses, surgeries, and lifestyle habits are reviewed.

The main goal of the diagnostic process is to assess ovulation, sperm production, tubal patency, and whether the uterine environment is suitable for pregnancy. For this reason, tests for both the woman and the man are planned simultaneously.

Diagnosis and Tests for Female Infertility

Evaluation of female infertility aims to identify the structural and functional status of the reproductive organs. The tests performed provide important information about ovarian reserve, hormonal balance, and uterine and tubal health.

Ovarian Reserve Tests

Ovarian reserve provides information about the number and quality of a woman’s eggs. This reserve naturally declines with age and directly affects the chances of pregnancy.

• AMH (Anti-Müllerian Hormone) test
• FSH and LH hormone tests
• Estradiol (E2) measurement
• Antral follicle count (via ultrasound)

These tests are usually performed on specific days of the menstrual cycle and help predict how the ovaries may respond to treatment.

Ovulation Monitoring and Hormone Tests

Ovulation disorders are among the most common causes of female infertility. Not every woman with regular menstrual cycles necessarily ovulates.

Hormone tests, ultrasound monitoring, and, if necessary, progesterone measurements are used to evaluate ovulation. These tests help determine whether ovulation occurs and when it takes place.

Evaluation of the Uterus and Fallopian Tubes

For pregnancy to occur, the uterine cavity must be healthy and the fallopian tubes must be open. Therefore, assessment of the uterus and tubes is essential.

• Hysterosalpingography (HSG)
• Saline infusion sonography (SIS)
• Hysteroscopy
• Laparoscopy

These methods can detect uterine polyps, fibroids, adhesions, and tubal blockages.

Diagnosis and Tests for Male Infertility

Evaluation of male infertility is often completed in a shorter time but is just as important as female evaluation. Male factors contribute to infertility in approximately half of all couples.

Semen (Sperm) Analysis

The most fundamental test in male infertility is semen analysis. This test evaluates sperm count, motility, and morphology.

Semen analysis is typically performed after 3–5 days of sexual abstinence. If abnormal results are found, the test may be repeated.

Hormonal and Genetic Tests

In men with impaired sperm production, hormonal tests and genetic evaluations may be performed. These tests are important for identifying the underlying causes of sperm production disorders.

• FSH, LH, and testosterone levels
• Genetic karyotype analysis
• Y chromosome microdeletion tests

Additional Diagnostic Methods in Infertility

In some cases, standard tests may not provide sufficient information. In such situations, advanced diagnostic methods may be required.

• Genetic testing
• Immunological tests
• Endometrial evaluations

These tests can be particularly helpful in cases of recurrent failed IVF attempts and repeated pregnancy losses.

Unexplained Infertility

When no cause can be identified despite comprehensive diagnostic testing, the condition is defined as unexplained infertility. In such cases, the problem may exist at a microscopic level and may not be detectable with current tests.

In unexplained infertility, assisted reproductive techniques such as intrauterine insemination (IUI) or in vitro fertilization (IVF) can increase the chances of pregnancy.

The Importance of Individualized Evaluation in Infertility Diagnosis

The causes of infertility vary from couple to couple. Therefore, the diagnostic process should always be personalized and not limited to standard approaches.

An accurate diagnosis helps prevent unnecessary treatments and allows the most effective therapy to be selected in the shortest possible time. Infertility diagnosis and testing represent the first and most important step on the path to a healthy pregnancy.