3 Fertility Tests to Tell You Why You Can’t Get Pregnant

If you’re having trouble conceiving and have already tried the basic female fertility tests, you might want to think about going a step further. These three medical tests are designed to help women know if they can get successfully get pregnant and carry a baby to term: uterotubogram or hysterosalpingogram (hsg), an endometrial biopsy, and a laparoscopy.

“Fertility workups are expensive, and unfortunately, medical insurance coverage can be limited, even for infertility diagnosis,” write the experts in Our Bodies, Ourselves: The Boston Women’s Health Book Collective.

Fertility tests can get expensive, but at least they’ll give you an idea of why you’re not getting pregnant and whether or not you can conceive a baby. We had a complicated genetic test done, which determined the cause of male infertility (my husband has azoospermia). We got the test too late, and wasted a lot of money trying to get pregnant before learning why I wasn’t conceiving.

These fertility tests include an uterotubogram or hysterosalpingogram (hsg), an endometrial biopsy, and a laparoscopy.

Uterotubogram or hysterosalpingogram (HSG)

An HSG looks at your fallopian tubes and determines if there are any blockages. Dye is injected into the vagina, and X-rays are taken. This fertility test wasn’t painful for me, but the doctor said that the dye can cause cramping. He also recommended taking a basic painkiller (such as Tylenol or Aspirin) half an hour before the HSG.

If you’re still wondering what an HSG is, here’s a great explanation from a fertility clinic:

An HSG is done after the menstrual flow has just stopped – usually on Day 6 or 7 of the period, at which time the lining of the uterus is thin. It is done in an X-ray Clinic. You should take an antibiotic and a pain-killer before the procedure. After being positioned on the X-ray table, the doctor places a special instrument into your cervix – a cervical cannula – which is made of metal. Many doctors now prefer to use a balloon catheter because it reduces pain. A radio-opaque dye is then injected into your uterine cavity.This is done slowly under pressure, and pictures are taken. The dye flows into the uterine cavity, then into the tubes, and from there into your abdomen. X-ray pictures taken. This fertility test for women provides a permanent record.

According to Our Bodies, Ourselves: Pregnancy and Birth, pregnancy rates are slightly increased in the cycle immediately following this fertility test for women, perhaps because the dye “cleans out” any mucus plugs in the fallopian tubes.

Can You Get Pregnant? 3 Fertility Tests

Endometrial biopsy

This fertility test reveals if you’re ovulating, and if your uterine lining is thick enough for embryo implantation. Don’t take this test if you think you’re pregnant; it could cause miscarriage. This biopsy involves the doctor inserting a small instrument into your uterus after partially dilating your cervix (this causes painful cramping!), scrapes tissue from your uterus, and examines it under a microscope.

“An endometrial biopsy is a way for your doctor to take a small sample of the lining of the uterus. The sample is looked at under a microscope for abnormal cells. An endometrial biopsy helps your doctor find problems in the endometrium. It also lets your doctor check to see if your body’s hormone levels that affect the endometrium are in balance.” ~ from Endometrial Biopsy on WebMD.


This is one of the most invasive infertility workups, and the only test that can confirm endometriosis (which can be a reason for not getting pregnant). The doctor makes an incision near your belly button and inflates your abdomen with carbon dioxide gas. Sometimes dye is flushed through your fallopian tubes, to see if they open. This test requires spinal or general anesthesia. If there is scar tissue because of endometriosis, the doctor can remove it right then – and perhaps increase your chances of getting pregnant!

The only fertility test I’ve had is the HSG, because female fertility isn’t our problem. But, since I’m almost 40 and have never been pregnant, I may have to undergo the other two tests to see if I can conceive a baby.  Ugh. My next one is the Clomiphene Challenge Test.

If you’re having trouble conceiving and/or carrying a baby to term, read Why Can’t You Get Pregnant? 4 Fertility Checklists.


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5 thoughts on “3 Fertility Tests to Tell You Why You Can’t Get Pregnant”

  1. My sister in law is under fertility treatments for over five years. Her gynecologists have suggested performing the above tests posted above. It is highly recommended to choose the right medical centres when going for fertility tests. This can help in accurate and reliable medical reports. Thanks for the post. I am praying for my sister in law’s fertility tests.

  2. Hi Hannah,

    Thanks for your comment. I checked out your website, and think you probably know a thing or two about fertility tests that help women know if they can conceive! 🙂

  3. Hello, I love your blog! I also wanted to say there is a very inexpensive test that is available in most stores. I do not remember who it is buy but it is called, Fertility Test and is around $20-30 I believe. At least when I used it. I have had 8 miscarriages before conceiving our 5 children and I took this test about 2 years ago. I could not get pregnant and my husband and I were considering testing. We decided to try this test first and it said I was fertile, so we continued to try for a couple months and we conceived a few months later. I’m not sure what others experience has been, but what people need to remember is that it is not always the women who is having the problem.

    Thanks for a great post. Wishing you all the best!