Female fertility testing

Before commencing any fertility treatments doctors at specialist reproductive will probably need to run a series of tests to discover the chances of the fertility treatment being able to work.

Doctors need to test for the ability of the endometrium to respond to oestrogen and progesterone in addition to test the ovaries for their ability to produce viable eggs.

Testing endometrium function:

Kallmann's or HH is usually first noticed in women by the absence of menstruation (amenorrhea).

In normal situations the endometrium is built up under the influence of progesterone and oestrogen combined. When progesterone levels fall to their lowest levels the endometrium is released from the lining of uterus.

Progesterone-induced withdrawal bleeding

A dose of progesterone is given over 5 days. After a week, menstruation should occur if the endometrium is functioning correctly under the influence of oestrogen.

Women with HH with no or very little oestrogen production will not produce menstruation under this test.

Progesterone / Oestrogen combined induced withdrawal bleeding

In this test both hormones are used to mimic the normal monthly supply of oestrogen and progesterone over the course of a month.

Oestrogen: - 28 days
Progesterone: - last 10 days of the month or cycle.

Menstruation should occur within 7 to 10 days after the last dose of progesterone.

It may take a couple of cycles, to produce the desired effect, especially if oestrogen has been absent for a long period of time.

Failure to produce menstruation may indicate other problems with the uterus which may need further investigations.

Ultrasound:

Ultrasound screening is sometimes used to visualize the presence of the ovaries and to test for the presence of 'streak ovaries'.

Regular testing is required throughout the course any fertility treatment to monitor the affect on the ovaries and uterus and to prevent the chances of any hyper-stimulation of the ovaries.