How Do Fertility Tests Work?

Whether you need fertility testing because you’ve been unable to conceive, wish to donate your eggs or sperm, or simply want to know more about your fertility and future options, it’s natural to feel a little nervous. Fortunately, knowing what to expect can help set your mind at ease. So exactly how do fertility tests work? Let’s talk about some of the most common fertility tests you may need. 

Semen Analysis

The first test for men is typically a semen analysis, which involves providing a semen sample that’s analyzed in a lab. Your doctor will check things like how much semen you produce, your semen’s pH  and whether it contains an abnormal amount of white cells, which can indicate an underlying health condition. Your sperm count, along with any issues – shape, movement, and maturity – will also be checked. 

Transvaginal Ultrasound

At RISE Fertility, your first visit always includes a transvaginal ultrasound to check for problems in your uterus, ovaries, and fallopian tubes. A transvaginal ultrasound also allows us to perform an antral follicle count, which provides information about your ovarian reserve and helps us estimate how many eggs we’d be able to retrieve for egg freezing or in vitro fertilization.

Hormone Level Testing

Hormones have a profound impact on your body, including your fertility. Hormones are involved in everything from sperm production and regulating your menstrual cycle to triggering ovulation and preparing the uterus for pregnancy. If any of your hormone levels are too high or low, it could interfere with your fertility. 

Testing your hormones also helps us estimate your ovarian reserve, whether or not you’re ovulating, and allows us to screen for conditions that may impact your fertility, including polycystic ovarian syndrome (PCOS), thyroid problems, and diabetes.

Transscrotal Ultrasound

If your semen analysis is normal, but you’re still having problems conceiving, we may do a transscrotal ultrasound to check for problems in your testes. We may also perform a transscrotal ultrasound to investigate any abnormalities we find during your physical exam. The ultrasound helps us see whether there are structural problems, swelling, or infections interfering with your fertility. 


During a sonohysterography, your doctor uses a catheter to fill your uterus with a saline solution. Sound waves from a vaginal ultrasound transducer bounce off the saline solution, helping your doctor see the structure of your uterus more clearly. 

A sonohysterography is useful for detecting things like uterine cancer, uterine fibroids, polyps, and scarring. It also helps your doctor determine whether your fallopian tubes are blocked and if you have any ovarian cysts.


A hysterosalpingogram, or HSG, is an X-ray dye test that helps your doctor tell whether your fallopian tubes are open and highlights other abnormalities. During the test, a dye is injected into your uterus through your cervix, which can help diagnose fertility problems arising from having blocked fallopian tubes.  


A hysteroscopy is another imaging test that helps your doctor see inside your uterus. A small camera is inserted through your cervix and into your uterus, which helps check for things like uterine fibroids, scarring, and other structural abnormalities. Your doctor is also able to take photos of the inside of your uterus to keep track of your condition over time. 

Endometrial Biopsy

Your uterine lining (endometrium) needs to be just the right thickness for implantation to take place. Fortunately, a biopsy of a small amount of tissue allows your doctor to examine your endometrium, analyze it for any problems and determine whether the lining is thick enough to support a pregnancy. 


Like a hysteroscopy, a laparoscopy uses a small camera to examine your reproductive organs, though this test is done by inserting a laparoscope through small incisions in your abdomen. 

The laparoscope provides a clear view of your uterus and other structures, and allows your doctor to treat common problems, like endometriosis and scarring, while you’re under anesthesia. 

Genetic Carrier Screening

Genetic conditions can sometimes impact your chances of conceiving, and couples often wish to know whether they carry genetic mutations that could be passed on to their children. 

Genetic carrier screening is a simple blood test that checks for hundreds of genetic conditions. However, this test only identifies whether you carry genetic mutations, and the results don’t mean that your child will have a genetic disease or condition. If you do have positive results, you should discuss the potential of passing on a genetic condition with your doctor or a genetic counselor. 

Preimplantation Genetic Testing

Preimplantation genetic testing involves testing your embryos to minimize the risks of having a child with a genetic condition. Testing is typically done on embryos during the IVF process before they’re chosen for implantation. 

Preimplantation genetic testing also helps your doctor screen your embryos for chromosomal problems that could prevent the embryo from implanting in your uterus or causing a miscarriage later on. 

Treating the Root Cause of Your Infertility

These are just some of the tests your doctor may choose to perform as part of your fertility assessment. Rest assured that your doctor will only perform tests determined by your unique medical history and physiology. But remember, more tests may be needed as you continue your fertility journey. 

What’s most important to remember is that fertility tests provide the necessary information to find the cause of your infertility and create a custom treatment plan just for you. Book a consult to learn more or to begin your fertility tests.

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