A fertility evaluation will begin with a thorough history and physical examination. Details such as the frequency of intercourse, regularity of menstrual cycles, medical history, previous gynecological problems, previous surgery, occupation, use of tobacco, alcohol or other drugs, and family history may suggest a reason why pregnancy is not occurring. In addition, physical findings such as a high body mass index, pelvic or genital masses or tenderness, excessive hair growth, an enlarged thyroid or nipple secretions might also point at a cause for infertility.
Preconception testing will also involve a Pap smear, cervical cultures and certain bloods tests.
Finally, other tests which will help to identify the cause for infertility include:
- A test to confirm ovulation
- A test to confirm that the fallopian tube(s) are open (e.g. HSG/ hysterosalpingogram, or FemVue)
- A pelvic ultrasound to evaluate the uterus and ovaries
- Other possible evaluations may include: sonohysterogram, endometrial biopsy, hysteroscopy, laparoscopy and a postcoital test