If you are considering infertility treatment, start the process if you've been trying to get pregnant for a year without results (or six months if you're 35 or older). "If you have a history of endometriosis or uterine fibroids or have had infertility problems in the past, go in as soon as you want to get pregnant," says Valerie Ratts, MD, associate professor of obstetrics and gynecology and an infertility specialist at Washington University School of Medicine, in St. Louis. Here's a step-by-step guide to the infertility testing process.

Step 1: Initial evaluation

Your doctor first examines you and outlines the tests you will undergo. Then your blood is tested to determine if the hormones that affect ovulation are at normal levels. Your husband may undergo a semen analysis to examine the motility, shape and count of his sperm.

If there's no problem in these areas, your doctor may do a tubal patency test to see whether your Fallopian tubes are blocked: Your cervix is filled with fluid and then x-rayed. If the fluid can travel from your uterus through the Fallopian tubes and spill out the end of the tubes, then they are clear.

Step 2: Additional tests

Your next series of tests may include a couple of options:

Transvaginal ultrasound ultrasound checks the ovaries for cysts and ensures that the uterine lining is thick enough to receive an embryo. A small instrument called a transducer is gently inserted into your vagina and will produce a picture of your organs on a video screen.

Laparoscopy may be performed if your doctor sees a problem during the ultrasound. After general anesthesia is administered, several small incisions are made in your abdomen. A telescope-type instrument called a laparoscope is inserted so your doctor can more closely examine your ovaries, uterus and Fallopian tubes.

Step 3: Treatments

If there are physical problems with your ovaries or uterus, your doctor will explain medication or surgery that could treat those conditions. If ovulation is the problem, your doctor will prescribe specific hormone treatments (such as thyroid hormone) or drugs (such as clomiphene citrate) that can help you ovulate.

If that treatment fails, you may be given daily shots of follicle stimulating hormone (FSH) to make your ovaries grow mature eggs. You'll receive the shots and be monitored for 9 to 14 days with ultrasounds and blood tests to see how the eggs are growing.

If your husband's sperm is a problem, your doctor may perform an intrauterine insemination (IUI) when you're ovulating. A sperm sample is collected from your husband, washed with a special solution and inserted directly into your cervix through a catheter.

Step 4: In vitro fertilization

If hormone treatments don't help or if there's a major problem with your husband's sperm, your doctor may perform in vitro fertilization (IVF).

You would take FSH shots for 10 to 14 days to help grow 5 to 10 eggs. If the eggs are in good shape, you'll be given the hormone human chorionic gonadotropin (HCG) to accelerate maturation. After 36 hours, your doctor will retrieve the eggs and place them in a petri dish. Your husband's sperm is added to the dish for fertilization. Twelve to 16 hours later, if the fertilization was successful, the fertilized egg should start dividing and become an embryo. The embryo is usually ready for implantation in your uterus three to five days after the eggs are harvested.

In vitro fertilization is a lengthy process that can cost $10,000 to $14,000 per cycle. (Check with your insurance company to see what may be covered.) For more information, talk to your doctor.