Fertility testing

Short description: Process for assessing human fertility

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Fertility testing

Medical diagnostics

ovulation prediction kit

Purpose| assess fertility

Fertility testing is the process by which fertility is assessed, both generally and also to find the "fertile window" in the menstrual cycle. General health affects fertility, and STI testing is an important related field.

## Contents

* 1 Women
* 1.1 Ovulation testing
* 1.1.1 Stretch test
* 1.1.2 Ovulation prediction kit
* 1.1.3 Electronic fertility monitors
* 1.1.4 Daily ultrasound
* 1.1.5 Serum progesterone
* 1.1.6 Cervical position
* 1.1.7 Basal body temperature charting
* 1.1.8 Calendar methods
* 1.2 Diagnostic testing for infertility
* 1.2.1 Anti-Müllerian hormone testing
* 1.2.2 Cycle-day-three follicle-stimulating hormone (FSH) testing
* 1.2.3 Clomiphene citrate challenge test (CCCT)
* 1.2.4 Antral follicle count
* 1.2.5 X-ray hysterosalpingography
* 1.2.6 Hystero contrast sonography (HyCoSy)
* 1.2.7 Saline infusion sonohysterography (SHG)
* 1.2.8 Hystero foam sonography (HyFoSy)
* 1.2.9 Ovarian ultrasound
* 1.2.10 Three-dimensional sonography
* 1.2.11 Hysteroscopy
* 1.2.12 Laparoscopy with chromotubation
* 2 Men
* 2.1 Male Fertility Testing
* 3 See also
* 4 References

## Women

Chance of fertilization by day relative to ovulation.[1]

Healthy women are fertile from puberty until menopause, although fertility is typically much reduced towards the extremes of this period. The onset of puberty is typically identified by menarche and the presence of secondary sexual characteristics such as breast development, the appearance of pubic hair and changes to body fat distribution. The end of fertility typically comes somewhat before menopause, as fertility declines to a point where establishing a viable pregnancy is very unlikely.

### Ovulation testing

Various methods of predicting the timing of ovulation exist, some of which may be performed at home or in a clinical setting. Knowing the timing of ovulation can help a woman to determine the days of the menstrual cycle that are most likely to result in conception.

#### Stretch test

Cervical mucus

The cervix is a structure between the vaginal canal and the uterus. The cervical cells secrete mucus that changes its consistency over different parts of the menstrual cycle. During the fertile window, the mucus increases in quantity and becomes clear and stretchy and is known as "egg-white cervical mucus." This mucus allows sperm to survive in and travel through it. In contrast, when outside of the fertile window, the mucus does not stretch, is sticky, and is not clear.

The stretch test can be performed prior to and immediately after urination. Mucus can be sampled with by either wiping with toilet paper or inserting a clean finger into the vagina. The mucus quality can then be observed by stretching the mucus between the finger and thumb as shown in the image.[2]

#### Ovulation prediction kit

Urinary ovulation prediction kits are typically found over-the-counter and there are many brands to choose from. This test measures the amount of luteinizing hormone, a hormone that increases just before ovulation, that is in the urine. Before ovulation, the luteinizing hormone levels dramatically increase; this is known as the "LH surge". This test can recognize the LH surge about 1-1.5 days prior to ovulation. Additionally, some ovulation prediction kits detect estrone-3-glucuronide. This is a breakdown product of estrogen and will have increased levels in the urine around the time of ovulation. This test is able to detect luteinizing hormone and estrone-3-glucuronide 90% of the time.

This test can be used in multiple ways. A few drops of urine can be added to the test device tip. Alternatively, the test device tip can be held in the urine stream. Finally, the test device tip can be dipped into a cup of urine. The test will indicate positive or negative results in about five minutes.[3]

#### Electronic fertility monitors

Fertility/contraception monitor

A fertility monitor is an electronic device which may use various methods to assist the user with fertility awareness. A fertility monitor may analyze changes in hormone levels in urine, basal body temperature, electrical resistance of saliva and vaginal fluids, or a combination of these methods. These devices may assist in pregnancy achievement. An updated 2023 Cochrane review has found that the use of urine ovulation test probably improves life births in women under 40 but that further study on risk and benefits is needed on timed intercourse via the use of these test.[4]

#### Daily ultrasound

Daily ultrasounds are used to follow the development of follicles which can help predict ovulation. The ultrasounds can predict ovulation with a 24-hour overlap to actual ovulation.[5]

#### Serum progesterone

Serum progesterone level is measured during the mid-luteal phase of the menstrual cycle. In women who are experiencing infertility, this test is only somewhat helpful for predicting ovulation.[6]

#### Cervical position

The cervix becomes soft, high, open and wet during the fertile window.

#### Basal body temperature charting

Basal body temperature changes during the menstrual cycle. Higher levels of progesterone released during the menstrual cycle causes an abrupt increase in basal body temperature by 0.5 °C to 1 °C at the time of ovulation.[7] This enables identification of the fertile window through the use of commercial thermometers. This test can also indicate if there are issues with ovulation.[8]

#### Calendar methods

In women who have regular menstrual cycles, the fertile window occurs at approximately the same time every month. If the first day of menses is considered day 1, then ovulation occurs around day 14. In regular cycles that are 26–32 days long, the fertile window occurs on days 8–19.[9]

### Diagnostic testing for infertility

Main article: Female infertility

Women who are of fertile age may be infertile for a number of reasons. Various diagnostic tests are available to establish reasons. Several diagnostic procedures and clinical instruments are used for to evaluate anatomical causes of infertility. Some use a combination of imaging such as an X-ray or ultrasound with a contrast agent to visualize anatomic structures within the uterus and fallopian tubes. An electronic, flexible scope with a camera can also be inserted through the cervix to display live images. A variety of hormones can be tested at different times in the menstrual cycle to determine the likelihood of different responses to stimulation for In vitro fertilization (IVF).

Pregnancy rates in ovulation induction when using antiestrogens, as functions of the size of the leading follicle as measured by transvaginal ultrasonography at days 11 - 13 (bottom scale), as well as the thickness of the endometrial lining (4 different curves).[10] Test  | Method  | Invasiveness

|
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Anti-Müllerian hormone testing  | Lab test  | Blood draw
Cycle-day-three follicle-stimulating hormone (FSH) testing  | Lab test  | Blood draw
Clomiphene citrate challenge test (CCCT)  | Lab test  | Blood draw
Antral follicle count  | Ultrasound imaging  | Non-invasive
X-ray hysterosalpingography  | X-ray imaging  | Minimally invasive
Hystero contrast sonography (HyCoSy)  | Ultrasound with contrast dye  | Minimally invasive
Saline infusion sonohysterography (SHG)  | Ultrasound with saline  | Minimally invasive
Hystero foam sonography (HyFoSy)  | Ultrasound with foam  | Minimally invasive
Ovarian ultrasound  | Ultrasound  | Minimally invasive
Three-dimensional sonography  | Ultrasound with 3D imaging  | Minimally invasive
Hysteroscopy  | Transvaginal endoscope  | Invasive
Laparoscopy with chromotubation  | Abdominal laparoscope  | Invasive

#### Anti-Müllerian hormone testing

Anti-Müllerian hormone (AMH) is a glycoprotein hormone produced by granulosa cells in preantral and small antral follicles of the ovaries.[11] Testing for plasma levels of AMH allows physicians to estimate ovarian reserve. Estimations of ovarian reserve help to determine the likelihood of pregnancy by In vitro fertilization (IVF). AMH testing is considered to be one of the most accurate estimates of ovarian reserve, can be used for assessment at any point in the menstrual cycle, and is non-invasive.[12]

#### Cycle-day-three follicle-stimulating hormone (FSH) testing

Follicle-stimulating hormone (FSH) is a peptide hormone which causes the primordial follicles in the ovaries to develop and to produce estrogen.[13] FSH levels are elevated early in the cycle of women who have lower ovarian reserve, because their follicles do not produce enough estrogen to inhibit FSH production,[14] therefore high levels early on in a woman's menstrual cycle can indicate lower ovarian reserve and lower likelihood of retrieving eggs for IVF. To test for ovarian reserve in women with infertility, FSH levels are measured from blood samples taken on day three of the menstrual cycle and compared to standards to determine the likelihood of pregnancy after IVF treatment.

#### Clomiphene citrate challenge test (CCCT)

The clomifene citrate challenge test is similar to cycle-day-three FSH testing. To perform this test blood samples are taken on day three of the menstrual cycle to obtain FSH and estradiol levels, then 100 mg of clomiphene citrate are given orally once a day on days 5 through 9 of the menstrual cycle, and finally on day 10 of the menstrual cycle a second blood sample is taken to measure FSH levels. CCCT is not better at predicting ovarian response in IVF patients than baseline FSH on day 3.[15]

#### Antral follicle count

Antral follicles are cells early in the process of developing from an oogonium into a mature oocyte. A physician may use a transvaginal ultrasound to visualize and count the number of antral follicles in each of a woman's ovaries in order to determine her ovarian reserve; however AFC is not predictive of embryo quality.[12] A higher number of antral follicles indicates a higher likelihood of pregnancy by IVF.

#### X-ray hysterosalpingography

Hysterosalpingography (HSG) is an invasive x-ray imaging technique used to evaluate the shape and size of the uterus and openness of the fallopian tubes. It is a diagnostic test used in the investigation of infertility from genetic or infectious causes such as uterine fibroids, uterine polyps, uterine anomalies, scarring or tumors.[16]

A HSG is performed after menses and before ovulation during the first half of a menstrual cycle. It is not performed if the patient is pregnant, has a pelvic infection, or heavy bleeding at the time of the test.[17]

The procedure usually takes 30 minutes and often takes place in an outpatient setting such as a hospital or clinic. The patient is draped and positioned on her back as if for a pelvic exam with feet elevated. A speculum is used to visualize the cervix. The cervix is cleaned with an antiseptic and injected with a local anesthetic to minimize discomfort and pain. A small catheter is used to fill the uterus with an iodinated contrast dye. X-ray images are taken as the contrast dye makes its way through the uterus and fallopian tubes. After images have been captured, the catheter is removed and contrast dye may either spill outside of the vagina or become absorbed.[16][17]

Risks associated with HSG are rare and include exposure to radiation, infection, allergic reactions to the contrast dye or antiseptic. It is normal for patients to experience mild to moderate abdominal cramping, pain and vaginal spotting for a few days after the procedure.[16]

#### Hystero contrast sonography (HyCoSy)

A vaginal ultrasound is used in Hystero contrast sonography (HyCoSy).

Hystero contrast sonography (HyCoSy) is a transvaginal ultrasound imaging technique used to evaluate the uterus, fallopian tubes and ovaries. It is a screening test used to determine the need for a diagnostic laparoscopy.[18]

A HyCoSy is typically performed after menses and before ovulation during the first half of a menstrual cycle. Unlike a HSG, a HyCoSy can be used to investigate causes of heavy bleeding.[19]

The procedure usually takes 15–20 minutes and often takes place in an outpatient setting such as a hospital or clinic. The patient is draped and positioned on her back as if for a pelvic exam with feet elevate. A speculum is used to visualize the cervix. The cervix is cleaned with an antiseptic such as iodine and injected with a local anesthetic to minimize discomfort and pain. A small catheter is used to fill the uterus and fallopian tubes with a contrast agent consisting of a galactose solution called Echovist to enhance visibility. A transvaginal ultrasound is inserted into the vagina and manually positioned to visualize the uterus, fallopian tubes, and ovaries. Once images have been captured, the ultrasound probe and catheter are removed. The contrast agent used during the study may either spill outside of the vagina or become absorbed.[18]

HyCoSy does not carry the same risks as X-ray hysterosalpingography because it does not use radiation or iodinated contrast dye.

#### Saline infusion sonohysterography (SHG)

Saline infusion sonohysterography is identical in procedure to hystero contrast sonography (HyCoSy) but uses saline instead of a contrast agent.[18]

A laparoscope is a minimally-invasive surgical technique used in infertility diagnosis.

#### Hystero foam sonography (HyFoSy)

An alternative to saline and Echovist, the galactose solution used to enhance visualization of anatomic features via ultrasound in HyCoSy, was needed because of limitations and high costs.[18] A sterile gel foam designed for gynecological use paved the entry for a new technique called hystero foam sonography (HyFoSy). The gel offers more stability than saline and patients may experience less discomfort and fluid leakage.[18]

#### Ovarian ultrasound

Ultrasound scans of the ovaries (optimally by transvaginal ultrasonography) may be conducted to establish the development of ovarian follicles. This can be useful particularly in the diagnosis of polycystic ovary syndrome.

#### Three-dimensional sonography

Three-dimension sonography is a 3D ultrasound technique that uses a series of 2D images to render 3D images of the uterus and fallopian tubes.

#### Hysteroscopy

Hysteroscopy is used to visualize the inside of the uterus using a thin, lighted, flexible camera that is inserted vaginally and through the cervix. The camera projects live images on an external screen. It is used to evaluate intrauterine causes of infertility.

#### Laparoscopy with chromotubation

Laparoscopy is a minimally-invasive surgical procedure in which a camera is inserted into the abdominal cavity via a small (0.5 - 1.5 cm) incision. It is often used to diagnose endometriosis. Chromopertubation is a combined laparoscopic procedure commonly referred to as a "laparoscopy and dye" test. It uses the injection of a blue dye solution (methylene blue or indigo carmine) into the uterus to help determine the openness of the fallopian tubes. Though considered to be a "gold standard" for diagnosing disorders of fallopian tube patency, it is an invasive procedure requiring general anesthesia.[20]

## Men

Main articles: Medicine:Semen analysis and Male infertility

Men who have gone through puberty should be fertile throughout life. The semen in ejaculate contains sex cells called sperm. After intercourse, sperm travel to the egg through the female reproductive tract, typically causing fertilisation to occur in the fallopian tubes.

Fertility testing for men involves semen testing and genetic testing, as other factors such as impotence are obvious. Semen can be tested for sperm count, sperm motility, sperm morphology, pH, volume, fructose content, oxidative stress, maturation assessment, DNA fragmentation and acrosome activity. Checks are also made to identify undescended testicles and retrograde ejaculation, along with medical history, such as cancer treatment, radiation, drug use, etc. In some cases the hamster zona-free ovum test may also be used to diagnose fertility. Genetic testing and chromosomal analysis can rule out some other causes of male infertility, such as Klinefelter syndrome.

A recent study identified epigenetic patterns in male sperm that may contribute to infertility.[21]

### Male Fertility Testing

Several diagnostic tests are used to evaluate male fertility by assessing sperm quality, function, hormone levels, and genetic integrity. These tests help determine the underlying causes of infertility and guide treatment strategies in assisted reproduction.

Semen Analysis (Spermiogram) is the standard test for evaluating male fertility. It measures key parameters such as sperm concentration (count), motility (movement), morphology (shape), volume, pH, and the presence of white blood cells or debris. The World Health Organization (WHO)[22] provides reference ranges for normal semen values. This test is often the first step in male fertility assessment.

DNA Fragmentation Test evaluates the integrity of the sperm's genetic material. High levels of DNA fragmentation are associated with reduced fertilization rates, impaired embryo development, and increased risk of miscarriage. Tests such as the TUNEL assay,[23] SCSA (Sperm Chromatin Structure Assay),[24] and Comet assay[25] are commonly used to measure DNA fragmentation.

Sperm Oxidative Stress Test assesses the presence of reactive oxygen species (ROS) that can damage sperm membranes and DNA. Excessive oxidative stress is a known contributor to male infertility. Tests like MiOXSYS[26] and chemiluminescence assays[27] are used to quantify oxidative stress levels and guide antioxidant treatment strategies.

Sperm Maturation Assessment evaluates the functional maturity of spermatozoa. Immature sperm may exhibit abnormalities in chromatin packaging, membrane composition, or the presence of residual cytoplasm. Techniques such as chromomycin A3 staining (CMA3),[28] hyaluronic acid binding assayst,[29] or nuclear protein transition studies[30] are used to assess sperm maturity, which is important for successful fertilization and embryo development.

Hormonal Blood Tests are performed to evaluate endocrine function, which plays a critical role in spermatogenesis. Commonly measured hormones include:

* Follicle-stimulating hormone (FSH) – regulates sperm production.
* Luteinizing hormone (LH) – stimulates testosterone production.
* Testosterone – essential for sperm development and libido.
* Prolactin – elevated levels can indicate pituitary disorders.
* Estradiol and sex hormone-binding globulin (SHBG) – help assess hormone balance.

These tests can help diagnose hormonal imbalances, hypogonadism, or underlying endocrine disorders that may affect male fertility.

## See also

* Infertility

## References

1. ↑ "Day-specific probabilities of clinical pregnancy based on two studies with imperfect measures of ovulation". Human Reproduction 14 (7): 1835–9. July 1999. doi:10.1093/humrep/14.7.1835. PMID 10402400.
2. ↑ "Cervical mucus testing – Pregnancy Info". https://www.pregnancyinfo.ca/before-you-conceive/fertility/tools-for-understanding-fertility/cervical-mucus-testing/.
3. ↑ Health, Center for Devices and Radiological (2018-11-03). "Ovulation (Urine Test)" (in en). FDA. https://www.fda.gov/medical-devices/home-use-tests/ovulation-urine-test.
4. ↑ Gibbons, Tatjana; Reavey, Jane; Georgiou, Ektoras X.; Becker, Christian M. (2023-09-15). "Timed intercourse for couples trying to conceive". The Cochrane Database of Systematic Reviews 2023 (9). doi:10.1002/14651858.CD011345.pub3. ISSN 1469-493X. PMID 37709293.
5. ↑ Queenan, J. T.; O'Brien, G. D.; Bains, L. M.; Simpson, J.; Collins, W. P.; Campbell, S. (August 1980). "Ultrasound scanning of ovaries to detect ovulation in women". Fertility and Sterility 34 (2): 99–105. doi:10.1016/S0015-0282(16)44889-2. ISSN 0015-0282. PMID 7409241.
6. ↑ Miller, Laura (April 2019). "Is a mid-luteal phase serum progesterone level accurate for predicting the ovulatory status of women?". Evidence-Based Practice 22 (4): 24–25. doi:10.1097/ebp.0000000000000232. ISSN 1095-4120.
7. ↑ Guyton and Hall textbook of medical physiology (12th ed.). Philadelphia, Pa.: Saunders/Elsevier. 2010. ISBN 978-1-4160-4574-8.
8. ↑ "Infertility Diagnosis". ARC Fertility. https://www.arcfertility.com/patient-resources/infertility-diagnosis/#endocrine.
9. ↑ "Rhythm method for natural family planning - Mayo Clinic". https://www.mayoclinic.org/tests-procedures/rhythm-method/about/pac-20390918.
10. ↑ "What is the optimal follicular size before triggering ovulation in intrauterine insemination cycles with clomiphene citrate or letrozole? An analysis of 988 cycles". Fertility and Sterility 97 (5): 1089–94.e1–3. May 2012. doi:10.1016/j.fertnstert.2012.02.018. PMID 22459633.
11. ↑ Moolhuijsen, Loes M. E.; Visser, Jenny A. (2020-11-01). "Anti-Müllerian Hormone and Ovarian Reserve: Update on Assessing Ovarian Function". The Journal of Clinical Endocrinology and Metabolism 105 (11): 3361–3373. doi:10.1210/clinem/dgaa513. ISSN 1945-7197. PMID 32770239.
12. ↑ 12.0 12.1 Fleming, Richard; Seifer, David B.; Frattarelli, John L.; Ruman, Jane (October 2015). "Assessing ovarian response: antral follicle count versus anti-Müllerian hormone". Reproductive Biomedicine Online 31 (4): 486–496. doi:10.1016/j.rbmo.2015.06.015. ISSN 1472-6491. PMID 26283017.
13. ↑ Orlowski, Michelle; Sarao, Manbeer S. (2021), "Physiology, Follicle Stimulating Hormone", StatPearls (Treasure Island (FL): StatPearls Publishing), PMID 30571063, https://www.ncbi.nlm.nih.gov/books/NBK535442/, retrieved 2021-09-13
14. ↑ Abdalla, H.; Thum, M. Y. (April 2004). "An elevated basal FSH reflects a quantitative rather than qualitative decline of the ovarian reserve". Human Reproduction 19 (4): 893–898. doi:10.1093/humrep/deh141. ISSN 0268-1161. PMID 15016786.
15. ↑ Hendriks, Dave J.; Mol, Ben-Willem J.; Bancsi, Laszlo F. J. M. M.; te Velde, Egbert R.; Broekmans, Frank J. M. (October 2006). "The clomiphene citrate challenge test for the prediction of poor ovarian response and nonpregnancy in patients undergoing in vitro fertilization: a systematic review". Fertility and Sterility 86 (4): 807–818. doi:10.1016/j.fertnstert.2006.03.033. ISSN 1556-5653. PMID 16962116.
16. ↑ 16.0 16.1 16.2 Radiology (ACR), Radiological Society of North America (RSNA) and American College of. "Hysterosalpingography" (in en). https://www.radiologyinfo.org/en/info/hysterosalp.
17. ↑ 17.0 17.1 "Hysterosalpingography: technique and applications". Current Problems in Diagnostic Radiology 38 (5): 199–205. September 2009. doi:10.1067/j.cpradiol.2008.02.003. PMID 19632497.
18. ↑ 18.0 18.1 18.2 18.3 18.4 "Hysterosalpingo contrast sonography (HyCoSy): let's make the point!". Archives of Gynecology and Obstetrics 291 (1): 19–30. January 2015. doi:10.1007/s00404-014-3465-4. PMID 25234517.
19. ↑ "Timing of sonohysterography in menstruating women". Gynecologic and Obstetric Investigation 50 (2): 144. 2000. doi:10.1159/000010302. PMID 10965203.
20. ↑ "Imaging techniques for assessment of tubal status". Journal of Human Reproductive Sciences 7 (1): 2–12. January 2014. doi:10.4103/0974-1208.130797. PMID 24829524.
21. ↑ "Aberrant sperm DNA methylation predicts male fertility status and embryo quality". Fertility and Sterility 104 (6): 1388–97.e1–5. December 2015. doi:10.1016/j.fertnstert.2015.08.019. PMID 26361204.
22. ↑ "WHO laboratory manual for the examination and processing of human semen, 6th ed" (in en). https://www.who.int/publications/i/item/9789240030787.
23. ↑ "Sperm DNA Integrity Tests | Center for Male Reproductive Medicine & Microsurgery". https://maleinfertility.org/understanding-male-infertility/fertility-evaluation/sperm-dna-integrity-tests.
24. ↑ "Sperm Chromatin Structure Assay (SCSA) | Center for Women's Health | OHSU". https://www.ohsu.edu/womens-health/sperm-chromatin-structure-assay-scsa#:~:text=The sperm chromatin structure assay,patient/couple experiencing 16 miscarriages..
25. ↑ Simon, Luke; Carrell, Douglas T. (2013). "Sperm DNA damage measured by comet assay". Spermatogenesis. Methods in Molecular Biology. 927. pp. 137–146. doi:10.1007/978-1-62703-038-0_13. ISBN 978-1-62703-037-3.
26. ↑ "Male InfertilityOxidative System" (in en-US). https://mioxsys.com/.
27. ↑ Dias, Tânia R. (2021). "Measurement of Reactive Oxygen Species in Semen Samples Using Chemiluminescence". Reactive Oxygen Species. Methods in Molecular Biology. 2202. pp. 103–109. doi:10.1007/978-1-0716-0896-8_9. ISBN 978-1-0716-0895-1.
28. ↑ Gómez-Giménez, Belén; Lacalle, Estíbaliz; Martínez-Pastor, Felipe; Soriano-Úbeda, Cristina (2025). "Analysis of the Chromatin Structure by Chromomycin A3 (CMA3) and Flow Cytometry". Spermatology. Methods in Molecular Biology. 2897. pp. 507–515. doi:10.1007/978-1-0716-4406-5_33. ISBN 978-1-0716-4405-8.
29. ↑ Davila-Garza, A.; Stronk, J.; Patrizio, P.; Huszar, G. (2013-09-01). "Role of the sperm-hyaluronic acid binding score (HBA-score) in andrological and fertility assessment: HBA-score values, sperm concentrations and total motile sperm content in semen of 768 men" (in English). Fertility and Sterility 100 (3): S437. doi:10.1016/j.fertnstert.2013.07.548. ISSN 0015-0282. https://www.fertstert.org/article/S0015-0282(13)01327-7/fulltext#:~:text=The sperm-hyaluronic acid binding test (HBA) is a,(RBM Online, 2007)..
30. ↑ Zhao, Ming; Shirley, Cynthia R.; Hayashi, Shotaro; Marcon, Ludovic; Mohapatra, Bhagyalaxmi; Suganuma, Ryota; Behringer, Richard R.; Boissonneault, Guylain et al. (April 2004). "Transition nuclear proteins are required for normal chromatin condensation and functional sperm development". Genesis (New York, N.Y.: 2000) 38 (4): 200–213. doi:10.1002/gene.20019. ISSN 1526-954X. PMID 15083521.

* v
* t
* e

Assisted reproductive technology

Infertility|

* Female
* Male
* Fertility clinic
* Fertility testing
* Fertility tourism

Fertility medication|

* Estrogen antagonists
* aromatase inhibitor
* clomifene
* FSH
* GnRH agonists
* Gonadotropins
* menotropins
* hCG

In vitro fertilisation (IVF)
and expansions|

* Assisted zona hatching
* Autologous endometrial coculture
* Cytoplasmic transfer
* Embryo transfer
* Gestational carrier
* In vitro maturation
* Intracytoplasmic sperm injection
* Oocyte selection
* Ovarian hyperstimulation
* Preimplantation genetic diagnosis
* Snowflake children
* Transvaginal ovum retrieval
* Zygote intrafallopian transfer

Other methods|

* Artificial insemination
* Ovulation induction
* Cryopreservation
* embryos
* oocyte
* ovarian tissue
* semen
* Gamete intrafallopian transfer
* Reproductive surgery
* Vasectomy reversal
* Selective reduction
* Sex selection
* Surrogacy

Donation|

* Donor registration
* Donor Sibling Registry
* Egg donation
* Embryo
* Sperm
* Semen collection
* Sperm bank
* Ova bank

Ethics|

* Accidental incest
* Genetic diagnosis of intersex
* Religious response to ART
* Mitochondrial donation
* Sex selection

In fiction|

* See subsection in sperm donation
* Reproduction and pregnancy in speculative fiction

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