The evaluation typically starts with a careful history of each woman's symptoms and previous experiences. This can include:
- A review of the pattern of menstrual cycle bleeding to help determine if ovulation is occurring and if other problems — such as aging of the ovary, or uterine defects like fibroids or polyps — are present.
- Collecting information that might suggest an anatomic problem with the tubes, such as questions about past history of sexually transmitted infections, painful periods or intercourse, and/or a previous abdominal surgery.
- Questions about prior surgery to the cervix or freezing for abnormal pap smears.
- A general review of systems to determine if other endocrine abnormalities might be contributing to infertility.
- A careful social history to evaluate for any environmental exposures or social habits such as smoking, drinking alcohol, drug use or extreme exercise, which could contribute to infertility.
Next, a physical examination is performed to evaluate the pelvic organs and assess potential hormonal problems.
Finally, additional hormonal testing or ultrasounds may be required to evaluate ovulation and ovarian age. An X-ray of the uterus and tubes, called a hysterosalpingogram or HSG test, may be completed to assess uterine or tubal status.
Surgical procedures — such as a laparoscopy, which uses tiny incisions and a scope to view the interior organs, or hysteroscopy, an endoscopic inspection of the uterus — may be indicated to evaluate the structure of the uterus or fallopian tubes in more detail.
UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.