Fertility testing

Overview

Fertility tests can help identify the causes of difficulty in conceiving. Experts generally recommend undergoing fertility testing if you and your partner have been unable to conceive after one year of regular, unprotected sex. Testing is used to diagnose and address infertility issues in both men and women.

Fertility tests are used by healthcare providers to identify the reasons behind infertility. These tests are usually recommended by fertility specialists if:

• After a year of consistent, unprotected sexual activity, you are under 35 years old and have not become pregnant.
• You are 35 years or older and have not achieved pregnancy after six months of unprotected sex.
• Your menstrual cycles are irregular; in particular, they are not longer than thirty-five days.

Types

 Fertility tests vary based on individual needs. At-home tests can help you determine whether you are ovulating and identify your peak fertility days each month. In-office tests are more comprehensive and aim to uncover the underlying reasons for difficulty in conceiving, guiding your provider in selecting appropriate treatments. To determine the most suitable fertility tests, a specialist will conduct a physical examination and inquire about your:

• Menstrual cycle history
• Gynecological history, including previous pregnancies
• Overall health history, including past surgeries or chronic illnesses
• Current prescription medications
• Caffeine and alcohol consumption
• Work environment, including potential exposure to toxins or chemicals
• Sexual history, including the frequency of intercourse

Based on this information, your fertility specialist will recommend specific tests. It’s important to note that there is no one-size-fits-all fertility test; specialists use a variety of diagnostic tools to understand why conception has not yet occurred.

• Here are some common female fertility tests:
  • Fertility Blood Tests: These tests check hormone levels in your blood at specific points during your menstrual cycle to identify imbalances that could affect egg production. Key hormones tested include progesterone, estradiol, thyroid stimulating hormone (TSH), and prolactin.
  • Genetic Testing: This test detects genetic mutations that may affect fertility.
  • Hysterosalpingogram: Using fluoroscopy, this test captures images of your uterus and fallopian tubes to check for blockages that may affect fertility.
  • Hysteroscopy: In this procedure, a hysteroscope—a thin, lighted tube—is inserted into your uterus to directly inspect the cervix and the uterine cavity.
  • Ovarian Reserve Testing: Also known as anti-mullerian hormone (AMH) testing, this combines blood tests with a transvaginal ultrasound to measure your antral follicle count (AFC) and AMH levels. It evaluates your egg count relative to your age and is particularly relevant for those considering in-vitro fertilization (IVF).
  • Pelvic Ultrasound: This imaging test provides detailed pictures of your reproductive organs to identify conditions like uterine fibroids or ovarian cysts.
  • Sonohysterogram: This imaging procedure uses fluid and ultrasound to examine the inside of your uterus, helping to identify potential causes of infertility.
• Here are some common male fertility tests:
  • Fertility blood tests: If semen analysis results indicate issues, blood tests will measure hormone levels such as testosterone, thyroid stimulating hormone (TSH), luteinizing hormone, prolactin, estradiol, and follicle-stimulating hormone (FSH) to identify potential imbalances.
  • Genetic testing: This test can uncover genetic variations that might affect fertility.
  • Post-ejaculatory urinalysis: This test checks for the presence of sperm in your urine, which can indicate a condition called retrograde ejaculation.
  • Semen analysis: This test evaluates the quantity and quality of sperm in your semen, providing insights into fertility.
  • Testicular ultrasound: Used to capture detailed images of the scrotum and testicles, this test helps identify possible causes of infertility if semen analysis results are abnormal.

Reasons for undergoing the procedure

The type of fertility test you need depends on factors like your assigned sex at birth, gender identity, health history, and sexual history. Tests may include blood draws, imaging, or a combination of both, aiming to determine the cause of infertility. Sometimes a single test is enough, while other situations may require a more comprehensive approach.

Your healthcare provider will evaluate your specific circumstances and give you detailed information about the recommended tests, how they are performed, how to prepare, and the treatment options available.

Risk

Fertility testing is generally safe, but like any medical procedure, it can carry some risks. Here are potential risks associated with different types of fertility tests:

• Blood tests: Pain, bruising, or infection at the needle site.
• Ovarian reserve testing: Discomfort from the ultrasound or a small risk of infection.
• Genetic Testing: Emotional stress from results.
• Pelvic ultrasound: Minor discomfort or irritation.
• Sonohysterogram: Cramping or spotting.
• Hysterosalpingogram: Cramping or an allergic reaction to the dye.
• Hysteroscopy: Cramping, bleeding, or infection.
• Semen analysis: Anxiety about results.
• Testicular ultrasound: Mild discomfort from the probe.
• Post-ejaculatory urinalysis: Minimal risk, with possible discomfort.

Procedure

If your test results are abnormal, your healthcare provider will discuss the next steps with you. Depending on your situation, you might need additional tests before starting treatment, or you might be able to begin fertility treatments immediately. Your healthcare provider will guide you through what to expect based on your specific circumstances.

Abnormal results don’t signify the end of your journey. While conceiving naturally can be challenging, your fertility specialist is there to assist you. There are many options available, including IVF and IUI, and your provider can offer resources and support to help you through the process.

At-home fertility tests are available online and at pharmacies. These tests can determine your most fertile days through urine or assess semen quality and volume.

However, at-home tests are not a replacement for professional evaluation. If these tests indicate potential issues with conceiving, it’s important to consult a fertility specialist. They can conduct more comprehensive tests and provide personalized treatment options.

Outcome

Fertility tests offer several benefits, including a precise diagnosis of reproductive health issues, which helps pinpoint specific factors that may be affecting your ability to conceive. These tests allow healthcare providers to customize treatments to fit your individual needs, potentially increasing the chances of a successful pregnancy. With clear results, you and your provider can make informed decisions about the next steps, whether that involves lifestyle adjustments, medications, or assisted reproductive technologies.

The results of fertility tests can reveal various factors impacting your ability to conceive, such as hormonal imbalances, structural issues with reproductive organs, or genetic conditions. Based on these findings, your healthcare provider can suggest targeted treatments or interventions to address the identified issues and enhance your chances of conception.