What Happens in Invasive Fertility Tests

When Blood Tests and Hormone Levels Aren't Enough

Infertility is a big issue and when it hits you personally, it is even bigger. In order to determine the reason for infertility a number of different diagnostic tests are done. Initially, these tests consist of blood work and checking hormone levels. However, there may be a need for more in depth, and perhaps invasive diagnostic testing to determine a course of action. Sometimes, the only way to know what is going on and to treat it is to get as close to the problem as possible. This can usually only be done through invasive means. In this article we will discuss some of the diagnostic tests and treatments that are performed, what they are, why they are done, and what you can expect to encounter when you are the patient.

Endometrial Biopsy

In order to diagnose luteal phase defect an endometrial biopsy is performed. The luteal phase is simply the second half of the menstrual cycle, the two weeks from ovulation to menstruation. It is called the luteal phase because this is the time when the corpus luteum, which only comes into being after the egg is released, starts to produce progesterone. If there is an insufficient supply of progesterone to support a pregnancy, the condition is called luteal phase defect.

The endometrial biopsy procedure is usually performed in the doctor's office during which a thin tube (catheter) is inserted through the vagina and cervix into the uterus where a sample is withdrawn to send to the lab for analysis. If the sample of endometrial lining is found to be "out of phase" (the date is off), another biopsy is usually done in a subsequent cycle, prior to a diagnosis.

The physiological effects of this procedure include some cramping that can register from mild to severe. There may be some spotting after the procedure that could go for a day to two. Over-the-counter pain medications are usually sufficient to help relieve the discomfort. The important caution here is that this test is usually done just before a woman's period is due, so having a pregnancy test performed prior to having the procedure is a good idea in order to avoid a possible miscarriage.

Hysterosalpingogram (HSG)

HSG stands for hysterosalpingogram, a method that allows the doctor to determine whether the fallopian tubes are fully open, to discover any uterine growth like fibroids or polyps, and also to see if there are any structural abnormalities. Fibroids are very common in a large number of women and usually they don't interfere with conception. However, there are times when they do and it is best to have them dealt with. If there are abnormalities in the uterus, such as a split uterus, then the doctor is able to diagnose it and determine if a pregnancy is viable.

To perform this procedure, the doctor injects a dye through the cervix and into the uterus and fallopian tubes. The movement of the dye is tracked through X-ray and the doctor can see the progress of the dye on a screen as it happens. If there is no radiologist present, then the films are sent to one for evaluation and an opinion. This procedure is generally performed in hospital as an outpatient. Some women carry on with their day afterward while others go home for a rest.

The effects of this test can be mild to severe cramping, some spotting for one or two days, and some discomfort that can be alleviated with OTC pain medications. The hidden bonus of this procedure is that many women actually do become pregnant within a few months of the test. This is probably due to the clearing out of the fallopian tubes accomplished by the dye when it is injected - the mucus is moved out and the tubes are open.