f a couple has not been successful in getting pregnant, there are a number of initial tests that can narrow down the issues to work on.

FOR HER

Low Stress Tests

• Post coital testing – Near ovulation, a sample of cervical mucus is obtained within 12 hours of intercourse. Mild to no discomfort.

• Clomiphene challenge test – Blood tests for FSH are done before and after the woman takes Clomiphene (Clomid) for 5 days. This helps determine egg quality and the likelihood of ovulation. Mild to no discomfort. 

• Ultrasound – A vaginal ultrasound is used to look at the ovaries and uterus. The lining of the uterus (endometrium) is measured and the number and size of the developing follicles, which contain the ripening eggs, is evaluated. This is especially important for women using fertility medications, who have fibroids or PCOS, or who are having IVF. Mild to no discomfort.

• Sonohysterography – A small amount of fluid is introduced into the uterus through a thin, flexible tube during an ultrasound. This may also be recommended to look for polyps or fibroids. Mild to no discomfort. 

Moderate Stress Tests 

• HSG (hysterosalpingogram) – X-rays are taken while dye is injected through the cervix, uterus, and fallopian tubes to determine the shape of the uterus and if the tubes are open. Scheduled after a period has ended and before ovulation. Mild to moderate discomfort.

• Endometrial biopsy – A thin tube is passed through the cervix to obtain a sample of the endometrium (lining of the uterus). Done in the luteal phase of the cycle, 10-12 days after ovulation. This helps determine if the uterine lining is able to receive a fertilized egg. Mild to moderate discomfort.

If it’s time to take the next step, there are many different options to help you get pregnant.

Limited Interventions 

Here are some simple things to do to increase the likelihood of pregnancy. These may be advised before more aggressive treatment is started.

• Fertility awareness – Check your cervical mucus. During ovulation it is thin and clear, and looks like uncooked egg whites. This is the time to have intercourse.

• Urine tests for ovulation – LH surge predictors are urine tests that indicate when the hormone LH is increasing (surging). LH surges 24-36 hours before the egg is released. This helps you determine when to have intercourse.

• Increase the frequency of intercourse – 2 to 4 times per week is recommended.

To Do List

• Take a prenatal vitamin daily – Vitamins with 800-1000 mcg of folic acid help decrease the risk of neural tube (spinal cord) defects in babies.

• Improve your nutrition – Increase calcium to 1200 mg/day, aim for 4-5 servings of fruits and vegetables per day. 

• Consider an appointment with your health care provider – To discuss anything in your personal or family medical history that needs to be addressed before becoming pregnant.

• Stop smoking – Women who smoke have less chance of becoming pregnant. Smoking decreases sperm counts in men.

• Limit alcohol and caffeine – Both decrease fertility.

• Get plenty of sleep – This helps your body function at its best.

• Take care of yourself and your relationship – Just trying to become pregnant is stressful. It can overshadow everything else in your relationship and your life.

• Stay balanced – Find time for each other and activities that do not revolve around getting pregnant. 

See also: Fertility Treatments 101