Several tests performed by your doctor or reproductive endocrinologist will help diagnose the cause for your infertility. We already covered the tests your partner will go through in the section titled “Visiting Your Doctor.”

The tests for you range from very simple in-office tests no more invasive than a PAP smear or ultrasound to surgical procedures.

Post Coital Test
During the Post Coital Test the doctor takes a sample of your cervical mucus. The doctor will examine the cervical mucus under a microscope to determine if it is hospitable to sperm.

Timing is everything with this test; it must be performed four to 10 hours after sex when just prior to, during, or immediately following ovulation (i.e., your fertile period, or the time of your cycle when you should be able to conceive.) Use an ovulation predictor kit to be certain, although you can certainly use other timing methods, including tracking BBT (Basal Body Temperature) and cervical mucus.

Do not:

• Use lubricant during sex

• Douche after sex

• Bathe or swim after sex (a shower is okay)

The doctor will take a small sample of cervical mucus and examine it for:

• Quantity – There should be more plentiful amounts during your fertile period;

• Consistency and clarity – It should be very thin and clear and also very stretchy, almost rubbery;

• Ferning – Under a microscope, the doctor should see a fern-like pattern in the dried cervical mucus, indicating the presence of estrogen without progesterone hormones;

• Cellularity – Few cells, other than sperm, should be present.

If any of these factors show problems, this could be the reason you are having difficulty conceiving. The doctor may recommend artificial insemination by means of intrauterine insemination in order to bypass the cervix all together.

However, the number one reason this test fails is poor timing; if the test was not done four to 10 hours after intercourse or was not done while you were ovulating, then the cervical fluid may not show a favorable environment for sperm to survive, swim and fertilize an egg. If this is suspected to be the case, a second test should be performed at the time of ovulation.

Other causes for an unfavorable cervical environment include:

• Infection or irritation. If this is the cause, testing will show white blood cells in the mucus.

• Procedures performed on the cervix to treat an abnormal Pap smear, such as freezing or laser treatment.

• Medications. Clomid (generic: clomiphene) a fertility drug used to treat infertility caused by anovulation, can have adverse affects on cervical mucus. If your doctor prescribes the drug or increases your dosage, he should perform a post-coital test to be sure the cervical environment is still hospitable to sperm.

Ultrasound
Most people think of ultrasounds as a non-invasive, painless procedure performed on pregnant women in order to see the unborn baby. True, an ultrasound can determine the gender, size (give or take 2 pounds), and often the general health of a fetus, but it can also give a doctor information about why you haven’t been able to conceive yet.

Your doctor will use an ultrasound to evaluate the condition of your ovaries and fallopian tubes, and check for cysts, tumors and uterine fibroids. He will be looking for Polycystic Ovarian Syndrome, endometriosis, and anything else that may be impairing your ability to get pregnant. An ultrasound can show the doctor if your eggs are developing properly and are being released from the ovaries and if the endometrial lining thickens sufficiently to permit implantation.

An endometrial biopsy is used to detect cancerous cells, precancerous cells, infections or any abnormalities that may be affecting your ability to conceive. The doctor inserts a thin catheter, called a pipelle, into the uterus and uses it to draw out cells for testing.

You may experience mild to intense cramping during and after the test. The doctor may recommend you take ibuprofen, such as Motrin or Advil, before and after the test to minimize cramping, or he may offer a prescription painkiller. You may have minor bleeding following the test.

You should take a pregnancy test prior to an endometrial biopsy since the procedure may terminate a very early pregnancy.

Hysteroscopy
A hysteroscopy is an out-patient procedure performed that will allow your doctor to spot abnormalities in the uterus such as:

• fibroid tumors

• polyps

• scar tissue

A hysteroscope is a very thin telescope with a camera on the end that can enter the cervix with no dilation. The uterus is expanded by means of saline solution or carbon dioxide, permitting the doctor to view the inside on a television monitor in the office. Minor cramping may result from the introduction of saline or carbon dioxide into the uterus, but the procedure is not considered especially painful.

Falloposcopy
Cleared by the U.S. FDA (Food and Drug Administration) in 1997 for use to diagnose fallopian tube blockages in women trying to conceive, falloposcopy is regarded as a relatively new and complicated procedure. However, since nearly 35 percent of all female infertility cases are related to fallopian tube damage, this procedure may be invaluable in determining the cause of infertility. Your doctor will probably order less invasive tests first, however, including an ultrasound.

Because the fallopian tubes are located so deep within the reproductive system, past diagnostic procedures carried a 40 percent rate of false diagnoses. The STARRT Falloposcopy procedure, patented by Conceptus, Inc., shows a much greater accuracy rate.

The procedure takes about 45 minutes and is performed with local anesthesia or intravenous sedation. Another benefit of the test is that tubes can be repaired at the same time, with the same equipment, if the doctor finds any abnormalities. Tubal repair can take as long as two hours and your doctor will use a general anesthesia. If abnormalities are found but the tubes cannot be repaired, your doctor will discuss the possibility of in vitro fertilization with you and your partner.

Similar to a hysteroscopy, a falloposcopy views the inside of the fallopian tubes by means of a camera inserted into the body. It enters through a catheter that travels through the cervix and uterus and finally, into the fallopian tube. A fiber optic endoscope with a camera on the end is then inserted through the catheter, so the doctor can view images on a television monitor in the office.

Risks include infection and bleeding, so your doctor may prescribe an antibiotic as a preventative measure.

Laparoscopy
Laparoscopic surgery is an advance in medical technology which permits diagnostic surgery through a very small incision, into which a thin instrument (laparoscope) is inserted in order to take pictures of the abdomen. Carbon dioxide is used to expand the abdomen, permitting the doctor with a clear view of the uterus, cervix, and ovaries and fallopian tubes on a television monitor in his office or in the operating room.

Doctors in the late 20th century commonly recommended this diagnostic procedure in couples trying to conceive. Today, however, other procedures are recommended first. Although laparoscopy is simpler and safer than traditional surgery with a full-size incision, it is still surgery, and often performed under general anesthesia. Rarely does a laparoscopy turn up any abnormalities not spotted by other fertility screening tests.

Hysterosalpigogram (HSG)
According to the Advanced Fertility Center of Chicago, a hysterosalpigogram is a common infertility diagnostic procedure that is helpful in detecting tubal infertility. Since 25 percent of all infertility is caused by tubal abnormalities, this test may be an important one. Less invasive than a laparoscopy, top fertility clinics makes it part of its basic fertility screens.

The test is performed in the radiology department of the fertility clinic, hospital or medical center between days six and 13 of the patient’s menstrual cycle.

Dye is injected into the uterine cavity, through the vagina and cervix. If the fallopian tubes are normal, the dye should spill out into the abdominal cavity. If there is a tubal blockage, the dye will stop at that point. The X-rays will be available for evaluation that day.

An HSG test also detects:

• uterine anomalies

• polyps

• fibroid tumors

• uterine scar tissue

• tubal defects

• scar tissue around the fallopian tubes

One of the most common problems spotted at the 20 week ultrasound is placenta previa. Placenta previa is where the placenta is nearby, or actually covering some or all of the cervix. It’s a potentially dangerous condition because if the placenta covers the cervix, it blocks baby’s way out, requiring a cesarean section to deliver the baby. And more seriously, as the cervix dilates towards the end of pregnancy, the placenta can be torn and bleed, which can be life-threatening to mom and baby.

Complete or partial placenta previa, where the placenta covers at least a quarter, or even all of the cervix, occurs in around 1 in 200 pregnancies, and requires careful monitoring by your doctor.

And more common is a marginal placenta previa, where the placenta is close by, or touching the cervix, but not actually covering it.

At 20 weeks, when the placenta is relatively large compared to the size of the uterus, many women appear to have placenta previa. The ultrasound technician will note the position of the placenta, so your doctor is aware and can discuss it with you. The doctor will probably tell you to avoid intercourse, heavy lifting, and strenuous activity. Your husband will be thrilled that he has to do the vacuuming instead of sex.

Several moms I know, including me, had marginal placenta previa at 20 weeks. At my next obstetrician appointment, the doctor explained what it was. The position of the placenta is largely random, but there are risk factors to placenta previa, including previous cesarean sections, a history of placenta previa, and it’s more common in older moms. Apparently, smoking or using cocaine also increases the risk, my doctor told me, raising one eyebrow. What? I’ve never smoked and the only kind of coke I know comes in a red can with a swirl on it.

The good news is that for most women who have marginal placenta previa at 20 weeks, as your uterus grows, the placenta gets further from the cervix and you’ll likely be given the all-clear to get back to normal activities by 24-28 weeks. Your doctor will schedule another ultrasound to check the position of the placenta at that time. If the placenta is now clear of the cervix, then vaccuming, etcetera are back on.

I had another ultrasound at 25 weeks, and like 90% of moms with marginal placenta previa at 20 weeks, my placenta was in a normal position, and the rest of my pregnancy went smoothly, except for having to think of other excuses to not vacuum.

If you are pregnant, and experience any vaginal bleeding, get checked by a doctor asap. If you have been told you have, or may have placenta previa, it is important to let the doctor who examines you know, as they will need to take extra precautions when they examine you to avoid causing any damage to your placenta.

Do you really want to know? Some couples choose to find out if they are having a boy or a girl from the moment they get pregnant, others know ahead of time that they want to be surprised. Other couples disagree, or don’t decide until the second trimester, when they are lying on the table having their ultrasound done and the technician asks, “Do you want to know the sex?”

The gender of your baby has much more importance than whether or not you are having a boy or a girl. In some cultures it is very important for there to be a son, and couples will try to have a son first. Some families have seconds and thirds, and want to have a boy so that they will have a fourth. Some families have an uneven number of boys and girls, so they hope to get the sex they need to even out their family.

Finding out ahead of time whether or not you are having a boy or a girl, helps the parents who are planning on doing a nursery and buying their child’s entire wardrobe prior to the birth of their baby. Newborn clothes primarily come in blue for boys and pinks for girls, with the occasional greens and purples mixed in. If you don’t know the sex it might be difficult to buy clothes as the choices for unisex clothes in greens, reds, yellows and oranges can be hard to find. Likewise there are a lot of nursery theme choices that cater to boys and girls, but fewer that can work for either sex. For the well organized parents, finding out the sex of their baby well before birth is the best way for them to plan for the arrival.

However, some parents choose to enjoy the element of surprise. They want to wait until the birth when their baby is laid on their belly where they can look between the legs and see the sex for themselves, or have the midwife or doctor announce loudly, “It’s a ….!” These parents buy the unisex clothes, although may choose to save money so that they can go on a big shopping spree after the baby is born, and only buy the clothes they will need in the first couple of weeks after birth. These parents will also choose to decorate their nursery in colors and patterns that can be utilized for either a boy or a girl baby.

There is no right or wrong answer to the question, “Do you want to know?” It is a personal choice made by each individual couple. It is often common for the answer to change several times, before that big day

Seeing your baby on an ultrasound can clearly be called the most anticipated part of a pregnancy, especially for couples who only get one ultrasound during their pregnancy that is paid for by their insurance. Those who are lucky get to see their baby, not only in the standard 2D view, but in 3D or even in 4D which is available in some areas of the world now.

Ultrasounds are not just meant for fun. They are used medically for many things during pregnancy, and they are often a necessity. During early pregnancy you a woman might be given an ultrasound for several reasons. Those reasons include previous health problems, a miscarriage or the threatening of a miscarriage, or to date your pregnancy. These types will always be done during the first trimester.

During the second trimester, normally between the 18th and 22nd week of pregnancy a woman will be given an ultrasound in order to check the baby’s lungs, heart, and brain, as well as to check for any other visible problems such as the possibility of Downs Syndrome. At this point, unless your baby is not cooperating, you can probably find out the gender of your unborn child if you want to know. Sometimes if the doctor or technician is unable to get the measurements and pictures he was looking for, they will attempt another ultrasound later in the second trimester.

If a woman chooses to have an amniocentesis, normally because of a bad test result, advanced maternal age, or previous health problems with a child, they will also have an ultrasound so that the doctor can watch as the needle enters the amniotic sac. This generally occurs around the 15th week of pregnancy.

During the third trimester an ultrasound may be offered to the parents in order to check the baby’s weight, because of lack of fetal movement, or while checking the baby’s health and stress level while doing a NST, or an amnio to check the development of the baby’s lungs.

Today pregnant women are lucky to have the option of paying out of pocket to receive an extended 3D or 4D ultrasound. These are normally not done by medical staff, but by offices as a business. They are more like souvenirs for the parents and the fee for them comes with the option to have video and pictures of their unborn baby that they can keep and show family and friends. These ultrasound sessions normally last between 30 and 90 minutes depending on what the couple pays for.

There are a lot of old wives tales regarding pregnancy. Everything from taking baths, to the accuracy of ultrasounds will have a tale to go along with it. However there are certain old wives tales that are specific to the gender of your baby.

Shape of Moms’ Belly
Some say if the woman’s belly is big and round it means that she is carrying a girl. Likewise, if her belly is smaller and sticking straight out than she is carrying a boy. The way a woman carries her baby has nothing to do with the sex, but has everything to do with the body shape and type that the woman naturally has, when not pregnant.

Direction of the Ring
Many people believe in the good old ring test as a way to tell what the sex of their baby is going to be. In this test you hang your wedding ring from a string over your belly. If the ring swings back and forth your baby is a girl. If it swings around in a circle then it is a boy. This is not very good indication of whether or not you are having a boy or a girl. Fact is, if you hang your ring over any object or person it is going to swing.

Fast Heart Rate Tale
Some people believe that if your baby has a fast heart rate, near 170 beats per minute, then that means you are having a girl, and that if your baby’s heart rate is closer to 150 beats per minute then you are having a boy. This also is false. You baby’s heart rate will get faster and stronger during the first trimester as he/she grows. Then the heart rate fluctuates in speed during sleep and active times for your baby, just like an adults. So depending on when you listen to your baby’s heart rate, it might be faster or slower than it was the day before, or even earlier that same day.

The Shape of Moms Face
Some people believe that the shape of your face determines the sex of your baby. If your face is round then you are having a girl, long and narrow means a boy. This is just a myth however because where a woman stores fat and water during pregnancy has nothing to do with the sex of their baby. Along with that some believe that if your nose starts to grow or widen then you are having a girl because daughters “steal” mom’s beauty. While this sounds like something out of a fairy tale, it is simply an old wives tale.

The Key Test
Then there is the key test. Some say that if you can tell your baby’s sex by picking up a single key. If you pick the key up by big, round (top) part then you are having a boy. If you pick it up by the narrow part on the bottom then you are having a girl. Then, as if it isn’t detailed enough, if you pick the key up by the middle you are having TWINS!

The Mayan Tale
If you are Mayan then you may follow their beliefs and use numbers to determine the sex of your baby. The Mayans take the mothers age at conception and the year of conception and add them together. If the result is a even number then mom is having a girl. If the result is an odd number then a boy is on the way! The Chinese have a similar way of determining the sex of a baby.

Drain-O Test
So many people believe this old wives tale which is completely false. They are told to put a tablespoon of Drain-O in a cup and pee into it. If the mixture turns green you are having a girl. If it turns blue you are having a boy. Supposedly there is something in the moms’ urine that mixes with the Drain-O causing it to change color and determine the baby’s sex.

Acne Myth
Acne during pregnancy is caused by hormones, not the sex of your baby. However, many believe that if you have an increased amount of acne during pregnancy then it means you are having a baby girl.

Cravings
This one sounds good and can be an “explanation” for many of moms’ cravings, but is it true? Some people say that if you crave salty food while pregnant it means you are having a boy and if you crave sweet food while you are pregnant it means you are having a girl. Does this mean that baby girls are sweet and baby boys are salty?

Do You Smell Like Garlic?
The question should be, “Do you WANT to smell like garlic?” There are people that swear that the garlic old wives tale is true. They say that if you eat a clove of garlic, and the smell comes out through your pores then you are having a boy. If no garlic is detected then you are having a girl. Who really wants to find out THAT bad though?!

Ultrasounds Are Always Right
This one is definitely false. We have heard many stories where a woman has received an ultrasound, and sometimes more than one ultrasound where the doctor claims that she is having either a boy or a girl. The mother buys everything she needs for her little son or daughter, and when the day of delivery comes she is surprised with a baby of the opposite sex. Most of the time the ultrasound technician gets it right, but that is not always the case.

These are just a few of the popular pregnancy old wives tales that deal with the sex of your baby. To see other pregnancy related old wives tales click here.

Amniocentesis, also referred to as simply an ‘amnio’, is a test that many women are offered and some take advantage of while pregnant. It is a test that analyzes the amniotic fluid that surrounds your baby while in utero. The amniotic fluid contains cells that match your baby’s and can give your doctor or midwife little clues and hints about your baby.

Amniocentesis is normally performed when a woman is between 15 weeks and 18 weeks pregnant. To perform amniocentesis your doctor or midwife will hook you up to an ultrasound machine and then insert a needle through your belly into the uterus and remove approximately 2 tablespoons of fluid to test and analyze. An amniocentesis can also be performed when you are 37 weeks or later in order to check your baby’s lungs and determine if they are mature enough for the baby could breathe on his own outside of the womb.

Amniocentesis is normally performed on women who are at high risk for a various number of reasons. These reasons might include

• Advanced maternal age (35 or older)
• Diabetes
• Previous children with medical problems at birth
• Abnormal triple screen results
• RH factor

Not only can amniocentesis determine if your baby is healthy or has any medical problems, but it can also unmistakeably determine the gender of your baby. For couples who want to know, ahead of the birth if they are having a boy or girl, is a pleasant and exciting plus to the amnio.

Amniocentesis is not done as a routine procedure during pregnancy because it does carry some risks. About 1 in 200 pregnancies will end in a miscarriage caused by the amniocentesis procedure. Therefore, an amnio is only performed when previous tests or ultrasounds suggest that there is a possibility of a severe medical problem. Even when this possibility exists, some women exercise their option of not having the test, and wait till their baby is born to deal with any problems he may or may not have. If you are not sure which choice is best for you, talk to your doctor or midwife.

During ultrasounds and when your baby is born, the nurses may tell you your baby’s weight in grams, which is the medical language of weight. Sometimes they will automatically tell you in pounds and ounces too, but other times they may assume you can figure it out and you may have to ask. Likewise at many well-checks your baby will be measured and you will be told how many grams he weighs. This can be very frustrating unless you have either lived in a country where they use grams instead of pounds, or have studied medicine on your own and know how to convert metric to imperial measurements.

Below are two charts that will help you easily convert grams to pounds and ounces so that you’ll have an idea of your baby’s weight in imperial measurements. Pounds are on the top, ounces are on the side. In order to find your baby’s weight locate the weight in grams in the center and then check to see the corresponding weight in pounds and ounces it lines up with. If you keep this chart handy, you’ll always have an easy way to know exactly what your baby weighs in pounds and ounces.

If you still find it confusing or find that it doesn’t make sense, be sure to ask the ultrasound technician or your pediatrician to translate grams to pounds and ounces for you. Chances are, if you don’t know what 3600 grams translates to, your friends and family won’t either!