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A complete history and physical examination of both partners is essential.
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Tests may include:
- Semen analysis -- the specimen is collected after 2 to 3 days of complete abstinence to determine volume and viscosity of semen and sperm count, motility, swimming speed, and shape.
- Measuring basal body temperature -- taking the woman's temperature each morning before arising in an effort to note the 0.4 to 1.0 degree Fahrenheit temperature increase associated with ovulation.
- Monitoring cervical mucus changes throughout the menstrual cycle to note the wet, stretchy, and slippery mucus associated with the ovulatory phase.
- Postcoital testing (PCT) to evaluate sperm-cervical mucus interaction through analysis of cervical mucus collected 2 to 8 hours after the couple has intercourse.
- Measuring serum progesterone (a blood test).
- Biopsying the woman's uterine lining (endometrium).
- Biopsying the man's testicles (rarely done).
- Measuring the amount of luteinizing hormone in urine with home-use kits to predict ovulation and assist with timing of intercourse.
- Progestin challenge when the woman has sporadic or absent ovulation.
- Serum hormonal levels (blood tests) for either or both partners.
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Hysterosalpingography (HSG) -- an x-ray procedure done with contrast dye that looks at the route of sperm from the cervix through the uterus and fallopian tubes.
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Laparoscopy to allow direct visualization of the pelvic cavity.
- Pelvic exam for the woman to determine if there are cysts.
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