Diagnostic Tests for Infertility

In order to get pregnant and successfully give birth, your uterus and fallopian tubes must be healthy and working properly. If blood tests do not determine the cause of infertility, your fertility doctor or Ob/Gyn will order additional tests.

There are several diagnostic tests physicians can use to see if your reproductive organs are functioning normally. You and your fertility doctor will determine which test is right for you based on your medical history and any symptoms you may be experiencing.

Tests to Assess the Fallopian Tubes

A blocked fallopian tube could prevent an egg from moving through the tube to the uterus or prevent sperm from reaching the egg. If your uterus has an abnormal shape due to fibroids or polyps, that abnormality may prevent a fertilized egg from attaching to the uterine wall and cause repeated miscarriages.

A hysterosalpingogram (HSG) is an X-ray that shows the inside of your uterus and fallopian tubes. The test is used to see if you have any structural abnormalities. An HSG is usually done two to five days after your menstrual period begins (the test should not be performed if you are pregnant). A thin tube is inserted through the cervix into the uterus. Then a small amount of dye is injected and an X-ray is taken. The dye outlines the inside of the fallopian tubes and uterus so the radiologist can see if there is a blockage and if so, where it is located. The radiologist also watches the dye to see if it moves. If you do not have a blockage, the dye goes through the tubes and into your belly. If you do have a blockage, the dye does not leave the fallopian tubes.

A newer test, called a sonohysterosalpingogram, is a non-radiologic method of assessing fallopian tubes and uterine shape with results that are comparable to HSG. This procedure can be done in the fertility doctor's office instead of seeing a radiologist. A sonohysterosalpingogram uses sterile saline and air, which is passed through the cervix into the uterus.

Tests to Assess the Uterus

The hysterosalpingogram and the sonohysterosalpingogram also assess the uterus, as does a saline sonogram, a test that can show uterine abnormalities such as polyps or cysts. This test is also called a saline sonogram, a sonohysterogram or a water ultrasound.

During the test, saline (salt water) is injected through your cervix to outline the inside of the uterus. This test uses ultrasound, not an X-ray, to let the radiologist watch the movement of the saline. The sonogram allows the radiologist to see not only inside the cavity of the uterus, but also the wall of the uterus at the same time to detect polyps or fibroids.

Some researchers believe that a saline sonogram is a more accurate test for evaluating the uterine cavity than a hysterosalpingogram or sonohysterosalpingogram.