Did you know that one in eight American couples will struggle with infertility when they try to have a baby? Infertility is a medical condition — not a lifestyle choice — and you are not alone. Many couples who struggle with fertility go on to have a healthy pregnancy with the right treatment.
For women under age 35, infertility is defined as one year of regular, unprotected sex without conception. For women over age 35, it’s six months of trying with no success.
To address infertility, we must first find out the causes. Common fertility tests include analyzing samples in the lab, performing imaging tests such as ultrasounds, and certain minimally invasive procedures like laparoscopy.
We always recommend that both the male and female partner get tested. There’s a misconception that most fertility issues are the woman’s problem. In fact, only about one-third of infertility is attributed to the female partner, one-third to the male partner, and one-third is caused by a combination of both.
Tests for Women: Ovulation
Problems with ovulation make it more difficult for a woman to get pregnant. When you meet with us for a consultation and fertility work-up, we’ll gather a detailed medical history to help us pinpoint your ovulation patterns.
One of the first questions we ask our patients is: Do you have regular periods? Regular menstrual cycles, as well as common symptoms like bloating, mood swings, breast tenderness and cravings, can often mean your ovulation cycles are normal. Irregular or no periods can mean the opposite.
We will also test your levels of progesterone, a hormone that prepares the uterus to receive, implant and support a fertilized egg during pregnancy. Progesterone levels are often low during the first stage of your menstrual cycle, but after ovulation, progesterone goes up and stays high until your period gets ready to start. Taking a blood sample about one week before your period starts can confirm whether you ovulated.
Tests for Women: Ovarian Reserve
Your ovarian reserve determines your ovaries’ capacity to provide viable eggs that could result a healthy and successful pregnancy. Testing ovarian reserve also provides information on the age of your ovaries, which may be different from your chronological age.
A quick and easy blood test that measures follicle stimulating hormone (FSH) and estradiol on your cycle Day 2, 3 or 4 can help us evaluate your ovarian reserve. Another option is to test anti-mullerian hormone (AMH) levels on any day of your cycle.
For women with polycystic ovary syndrome (PCOS), we may also test testosterone or dehydroepiandrosterone sulphate (DHEAS) levels. Abnormal levels of these hormones may make it more difficult to get pregnant.
Other routine labs we check during our standard infertility evaluation include thyroid tests and vitamin D levels. Abnormalities in these areas can indicate underlying medical conditions that may contribute to fertility problems.
Tests for Women: Uterus and Fallopian Tubes
In addition to lab work, we may also check for blockages or abnormalities with your uterus or fallopian tubes. If an egg can’t make it from the ovary to the uterus, it will be harder to get pregnant and can cause an ectopic pregnancy.
The most common way to check a woman’s fallopian tubes is through a hysterosalpingogram (HSG) imaging test, also known as the “dye test.” A special dye is injected, then we take an X-ray to observe the flow of the dye through your tubes.
Abnormalities in the size and shape of your uterus may also make it more difficult to conceive. An HSG test may detect possible irregularities, but we will likely need to do an ultrasound for a closer look.
Every woman who is struggling with infertility might also consider having a transvaginal ultrasound to evaluate the ovaries, as well as look for cysts, polyps, fibroids and endometriosis in and around the uterus. Problems in any of these areas can make it harder for you to become pregnant.
Tests for Men: Semen Analysis
The most common male fertility test is a semen analysis, which looks at both the sperm and semen, the fluid that carries sperm. Semen samples can be collected at home or at a specialist’s office, then evaluated in the lab.
Sperm will be evaluated for count, concentration, motility, morphology, pH level and other factors. Sperm count is the total number of sperm in a particular quantity of semen. Concentration refers to how densely packed those sperm are within the semen.
We will also test for motility, or the ability of the sperm to “swim,” which is essential for them to move through the female reproductive system and fertilize the egg. Morphology means the sperm’s structure or shape, which can impact its ability to penetrate an egg.
A simple sperm analysis might not offer conclusive results. In that case, we may recommend a more specialized test as a follow up, such as a DNA fragmentation index (DFI) test.
For more about male infertility, click here.
Once we’ve completed a thorough evaluation of both partners and gotten to the root of your infertility, we’ll create a customized treatment plan to help you conceive your family dreams. For more information, or to set up a consultation, please call our office at (502) 897-2144.
