Fertility Testing for Women

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How Female Infertility Is Diagnosed

Female fertility testing is designed to evaluate the key factors that influence a woman’s ability to conceive, including ovulation, hormone levels, and reproductive anatomy. These assessments help identify whether cycles are functioning as expected or if there may be underlying conditions affecting fertility. Because these factors can vary widely from person to person, testing is tailored to your individual health history and symptoms. The results provide a clearer picture of what’s happening and help determine whether any follow-up care or treatment may be needed.

What are the signs of female infertility, and when should I get tested?

While some women may experience noticeable symptoms related to infertility, such as irregular or very painful periods or a history of miscarriage, many underlying causes can be silent and show no obvious signs.

Infertility is typically defined as the inability to conceive after 12 months of trying, or after 6 months for women over age 35. Because symptoms aren’t always present, evaluation is often recommended based on how long you’ve been trying rather than how you feel. Even women who aren’t actively trying to conceive may benefit from earlier fertility testing if they have known risk factors or concerns about their fertility. Addressing these factors early can help support more informed decisions about future family planning.

Possible Causes of Female Infertility

Numerous factors can contribute to female infertility, such as hormonal imbalances, ovulatory disorders, abnormalities in the reproductive system, or age-related issues. Testing can help identify specific conditions, including:

  • Polycystic ovary syndrome (PCOS)
  • Endometriosis
  • Uterine fibroids or polyps
  • Blocked fallopian tubes (tubal factor infertility)
  • Primary ovarian insufficiency (POI)
  • Hormonal imbalances
  • Low ovarian reserve
  • Irregular or absent ovulation
  • Pelvic adhesions or scarring
  • Genetic or chromosomal conditions
  • Recurrent pregnancy loss
  • Unexplained infertility

Treatment is determined by the underlying cause of fertility issues, which can be assessed through various diagnostic evaluations.

What is AMH testing, and why does it matter?

Anti-Müllerian Hormone (AMH) is commonly used to assess ovarian reserve, or the number of remaining eggs. A simple blood test measures AMH levels, which can help estimate how many eggs may be available for ovulation or fertility treatment. Higher AMH levels generally suggest a greater number of remaining eggs, while lower levels may indicate diminished ovarian reserve. Because AMH naturally declines with age, it is often used as one piece of the overall fertility evaluation rather than a standalone measure of fertility.

What other female fertility testing is part of an overall evaluation?

Infertility evaluations include various assessments such as lab tests for hormone levels, imaging studies, and non-invasive diagnostic techniques to assess reproductive organ function and accurately diagnose potential issues.

Medical History and Physical Examination

By assessing a patient's past medical conditions, family history, and lifestyle factors, fertility specialists can uncover underlying issues that may affect reproductive health. Additionally, physical exams can help identify any anatomical abnormalities or signs of hormonal imbalances. This comprehensive approach enables clinicians to develop targeted treatment plans to improve the chances of successful conception and proactively address any fertility-related challenges. 

Ovulation Assessment

Evaluating ovulation can involve several methods, including cycle tracking, progesterone monitoring, and ultrasound. Cycle tracking helps individuals identify patterns in their menstrual cycles, while measuring progesterone levels indicates whether ovulation has occurred. Additionally, ultrasound monitoring enables observation of follicle development and the timing of ovulation. Together, these methods offer a comprehensive approach to understanding fertility and reproductive health.

Hormonal Testing

Hormonal testing plays a crucial role in understanding fertility health by assessing key reproductive hormones, including FSH, LH, estradiol, prolactin, and thyroid hormones. FSH and LH are essential for regulating the menstrual cycle and ovulation, while estradiol influences the thickness of the uterine lining. Prolactin levels can indicate i ssues with ovulation, and thyroid hormones are vital for overall fertility. These tests help identify potential hormonal imbalances that may affect fertility and inform appropriate treatment options.

Ovarian Reserve Testing

Ovarian reserve refers to the quantity and quality of a woman's remaining eggs and is a crucial factor in assessing fertility potential. Fertility specialists assess ovarian reserve through various tests, such as blood tests measuring hormone levels (like AMH and FSH) and ultrasound imaging to count antral follicles. Understanding ovarian reserve is vital for individuals or couples planning fertility treatments, as it helps to determine the best approach and can guide decisions regarding timing and options such as egg freezing or in vitro fertilization (IVF).

Hysterosalpingography (HSG)

HSG is a specialized X-ray procedure used to assess the health of the fallopian tubes and the uterine cavity. During the procedure, a contrast dye is injected through the cervix into the uterus, and X-ray images are obtained to visualize its flow. This can help identify blockages in the fallopian tubes, abnormalities in the uterine shape, or other issues that might affect fertility.

Transvaginal Ultrasound Testing

A transvaginal ultrasound is a valuable diagnostic tool for obtaining detailed images of the reproductive organs. This procedure involves a specially designed probe that is inserted into the vagina, allowing for closer visualization of structures such as the ovaries, uterus, and fallopian tubes. It is often used to evaluate conditions such as fibroids and cysts, as well as to assess early pregnancy. Transvaginal ultrasound is generally safe and provides critical information to guide treatment decisions.

Laparoscopy

Laparoscopy is a minimally invasive surgical procedure used to diagnose causes of infertility, such as endometriosis and pelvic adhesions. By making small incisions and using a camera, surgeons can obtain a clear view of the reproductive organs, enabling accurate diagnosis and treatment. This method not only shortens recovery time compared to traditional surgery but also helps identify issues that might otherwise go unnoticed.

Genetic Testing

Genetic testing may be recommended for female patients experiencing fertility issues to identify potential underlying genetic concerns that could affect their reproductive health. This testing can reveal chromosomal abnormalities, gene mutations associated with conditions like premature ovarian insufficiency, or hereditary disorders that may impact fertility. 

Saline Infusion Sonogram (SIS)

A SIS is a specialized ultrasound procedure used to evaluate the uterine cavity for abnormalities, such as polyps, fibroids, and other structural issues. During the SIS, a saline solution is injected into the uterine cavity, enhancing image quality and allowing a clearer view of the internal structures.

How much does female fertility testing cost?

The cost of female fertility testing varies based on the diagnostic tests recommended by your doctor. While some basic lab work and imaging may be covered by insurance, more advanced diagnostic procedures may require out-of-pocket expenses.

Regardless of your individual situation, Advanced Fertility Center of Chicago’s financial team will review your insurance plan and inform you of what to expect before you receive any care. We encourage patients to visit our pages on Fertility Treatment Costs, Financing, and Insurance Coverage for more information.

Female Fertility Testing FAQ

  • An AMH test provides insight into a woman's ovarian reserve, indicating the number of viable eggs remaining. Higher AMH levels suggest a greater quantity of eggs, while lower levels may indicate diminished fertility potential. This test is especially useful for women considering fertility treatments, as it helps assess their chances of success.

  • Doctors assess ovarian reserve primarily through blood tests and imaging techniques. Blood tests typically measure hormone levels, such as FSH, Estradiol, and AMH, on specific days of the menstrual cycle. An ultrasound can evaluate the antral follicle count, which indicates the number of potential eggs available. Together, these assessments help determine a woman's fertility potential and guide decisions regarding reproductive care.

  • During fertility testing, several hormone levels are measured to assess reproductive health. Key hormones include FSH, LH, estrogen, and progesterone. Additional tests may measure AMH and thyroid hormones, which are important for ovarian reserve and overall fertility. These tests help identify potential issues affecting fertility and guide treatment options.

  • An ultrasound may be a part of your fertility testing, as it helps evaluate the reproductive organs, including the ovaries and uterus. It can be essential for diagnosing conditions such as ovarian cysts and uterine abnormalities, as well as for monitoring follicle development during treatment cycles. Your healthcare provider will determine if an ultrasound is necessary based on your medical history and specific fertility concerns.

  • If you're over 35 and trying to conceive, it's advisable to consult a healthcare provider after six months of unsuccessful attempts. Early testing can help identify potential issues and determine the best course of action, ensuring you have the support and information you need for your family planning journey.

  • Insurance coverage for female fertility testing varies by policy and insurer. While some plans may cover basic fertility assessments, such as blood tests and ultrasounds, more advanced evaluations or treatments may incur out-of-pocket costs. Our financial team will ensure you understand your specific benefits, so you'll know what to expect before testing begins. 

Comprehensive Female Fertility Testing in Chicago

If you’re interested in learning more about your fertility in a compassionate and supportive environment, the experienced team at the Advanced Fertility Center of Chicago is here to help. We offer comprehensive fertility testing for individuals and couples in Chicago and the surrounding areas.

With convenient locations in Downers Grove, Gurnee, Chicago - River North, and Arlington Heights, we make it easy to access advanced fertility care close to home. Schedule your fertility evaluation today using our convenient self scheduler to gain clarity, confidence, and a customized plan tailored specifically for you.