Patient's question:
Consult about female infertility tests. I used to be pregnant before, and I had an abortion with medication at that time. Now I haven't been pregnant again.Doctor's answer:
1) Systematic examination, in addition to a general check-up, should also include a reproductive system examination. In addition to general visual and tactile examinations, vaginal speculum examination and internal examination (bilateral or triple vaginal examination) should be performed to preliminarily understand the general condition of the vagina, cervix, uterus, fallopian tubes, ovaries, and pelvic cavity, such as the size and position of the uterus, whether it is normal, whether there are masses, tenderness in the uterus, fallopian tubes, and ovaries, whether there is uterine elevation pain, and the mobility of the adnexa.(2) To determine whether ovulation occurs and predict the ovulation period: This can be judged through basal body temperature measurement, cervical mucus examination, or hormone testing.
(3) Endometrial examination: If necessary, a biopsy can be performed to understand the functional state of the endometrium. Additionally, cervical examination is a reliable method to determine whether ovulation occurs or whether the corpus luteum function is normal. It can also help assess the size of the uterine cavity and rule out cavity lesions, such as tuberculosis or uterine fibroids.
(4) Endocrine function testing: For example, serum estrogen and progesterone levels can be measured at different times during the menstrual cycle to assess ovarian function; the basal metabolic rate can be measured to evaluate thyroid function; adrenal function tests and serum prolactin measurements can also be conducted.
(5) Tubal patency examination: This includes tubal patency tests (such as tubal insufflation or tubal flushing) and hysterosalpingography, primarily to determine whether the fallopian tubes are patent and whether the development of the uterus and fallopian tubes is normal, as well as to identify any abnormalities. For individuals with suboptimal tubal patency (e.g., mild adhesions), these tests may also have a therapeutic effect.
(6) Immunological examination: To determine whether antisperm antibodies exist. In addition to antisperm antibody testing, indirect assessment can be made through post-coital tests or sperm penetration tests.
(7) Cranial (sella turcica) X-ray examination: To assess whether there are tumors or other lesions in the pituitary gland.
(8) Chromosome examination: Some infertility is associated with the presence of antisperm antibodies, so related immunological examinations may sometimes be necessary.
Additionally, infertility examinations should include both partners!