Infertility causes and testing

Cause: Problems with sperm

Test: Seminal fluid analysis (SFA)

  • Test after 2 to 7 days of not ejaculating.
  • Best if test is done at UI Health Care. If test is done locally, call when the test is done to be sure the results are faxed.
  • Normal samples have:
    • More than 15 million sperm/mL
    • More than 40% motility
    • More than 4% normal shapes

Cause: Ovulation problems

Test: Ovulation predictor kits (OPK)

  • Cycle day 1 is the first day of full menstrual flow.
  • Start home testing cycle day 11.
  • Test each day until positive or until cycle day 22.
  • Call your care team if you do not have a positive test by cycle day 21.

Test: Progesterone level

  • Test should be done 7 to 8 days after a positive OPK or on cycle day 21 if no positive OPK is seen.
  • Can be done locally and faxed to UI Health Care.
  • Level should be more than 3 to show ovulation.

Cause: Diminished ovarian reserve

Test: Antral follicle count (AFC)

Prefer AFC higher than 10.

Test: Anti-mullerian hormone (AMH)

Prefer AMH higher than 1.

Cause: Abnormal pelvic anatomy (uterus or fallopian tube)

Test: Ultrasound +/- saline infusion sonography (SIS)

Test: Hysterosalpingogram (HSG) or Femvue ultrasound

  • Prefer test be done at UI Health Care.
  • Cycle day 1 is the first day of full menstrual flow.
  • HSG is done on cycle day 5 to 13. Call on the 1st day of your period to schedule the test.
  • Take 600 mg of ibuprofen 30 minutes before the test.
  • Results will be discussed the day of the HSG or at a later visit.

Cause: Unexplained infertility

Test: Diagnosed when all tests are normal

Cause: Thyroid disease

Test: Thyroid stimulating hormone (TSH)

  • Normal is 0.2 to 4.2.
  • Greater than 4.2 shows hypothyroidism. Thyroid supplementation is suggested.

Cause: Rubella

Test: Rubella antibody testing

Immunity to rubella helps prevent congenital disease and birth defects if you were to become pregnant. We suggest checking for rubella immunity in all people planning to become pregnant. They should get a vaccine if they are not immune.

Last reviewed: 
January 2021

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