How Do I Get Fertility Tested

Fertility testing is an essential step for couples or individuals who are planning to have a child or are concerned about their reproductive health. It helps to identify any potential issues that may affect the ability to conceive and allows for appropriate medical intervention or lifestyle adjustments. Understanding the process of getting fertility tested is crucial in order to make informed decisions and take proactive measures. In this article, we will explore the various aspects of fertility testing, including when to consider it, the different types of tests available, and what to expect during the testing process.

When to Consider Fertility Testing

Age and Family Planning

For women, age is a significant factor. Generally, fertility starts to decline gradually after the age of 30 and more rapidly after 35. Couples who have been actively trying to conceive for a year without success, especially if the woman is 35 or older, should consider fertility testing. For example, a 36-year-old couple who have been having regular unprotected intercourse for 12 months and still not achieved pregnancy should seriously think about getting tested.

Medical History

If either partner has a history of certain medical conditions, it may warrant earlier testing. For instance, women with a history of irregular menstrual cycles, endometriosis, pelvic inflammatory disease, or previous ovarian surgeries may need to be evaluated sooner. Men with a history of testicular trauma, undescended testicles, or sexually transmitted infections might also require earlier fertility assessment.

Lifestyle Factors

Unhealthy lifestyle habits can impact fertility. Couples with a history of heavy smoking, excessive alcohol consumption, or long-term use of certain medications or drugs should consider testing. For example, a couple where one partner smokes a pack of cigarettes a day and the other has a history of binge drinking may want to get tested even if they haven’t been trying for a full year.

Types of Fertility Tests for Women

Ovulation Testing

Basal Body Temperature (BBT) Charting

Women can measure their basal body temperature every morning before getting out of bed. A slight increase in temperature indicates ovulation has occurred. For example, a woman records her temperature daily and notices a consistent rise of about 0.5 to 1 degree Fahrenheit around the middle of her menstrual cycle, which could suggest ovulation.

Ovulation Predictor Kits

These kits detect the surge in luteinizing hormone (LH) that precedes ovulation. A woman urinates on a test strip, and a positive result indicates that ovulation is likely to occur within the next 24 to 48 hours.

Hormone Testing

Follicle-Stimulating Hormone (FSH)

Elevated FSH levels in the early part of the menstrual cycle may suggest diminished ovarian reserve. A blood test is taken on the third day of the menstrual cycle to measure FSH. For example, if a woman’s FSH level is above 10 mIU/mL, it could be an indication of reduced ovarian function.

Luteinizing Hormone (LH)

In addition to its role in ovulation prediction, abnormal LH levels can also affect fertility. Abnormally high or low LH levels can disrupt the normal menstrual cycle and ovulation process.

Progesterone

A blood test for progesterone is usually done about a week after ovulation. Low progesterone levels may indicate a problem with the corpus luteum, which is essential for maintaining the uterine lining for implantation. For instance, if a woman’s progesterone level is below 10 ng/mL in the luteal phase, it might suggest an issue.

Pelvic Ultrasound

This imaging test allows doctors to visualize the ovaries, uterus, and fallopian tubes. It can help detect structural abnormalities such as ovarian cysts, uterine fibroids, or blocked fallopian tubes. The doctor may also be able to assess the number and size of the follicles in the ovaries, which gives an indication of ovarian function.

Types of Fertility Tests for Men

Semen Analysis

Sperm Count

The number of sperm in a semen sample is measured. A normal sperm count is typically considered to be at least 15 million sperm per milliliter of semen. For example, if a man’s semen analysis shows a sperm count of only 5 million per milliliter, it is below the normal range and could contribute to infertility.

Sperm Motility

This refers to the ability of sperm to move. At least 40% of sperm should have normal motility. If a significant portion of the sperm are sluggish or immobile, it can affect their ability to reach and fertilize an egg.

Sperm Morphology

The shape and structure of sperm are evaluated. Normal sperm have a specific shape that allows them to penetrate the egg. Abnormal sperm morphology can reduce the chances of successful fertilization.

Hormone Testing

Testosterone

Low testosterone levels can affect sperm production. A blood test is used to measure testosterone levels. If a man has symptoms such as low libido, fatigue, and reduced muscle mass along with low testosterone, it may be a factor in infertility.

Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH)

In men, abnormal levels of these hormones can also disrupt the normal process of sperm production. High FSH levels may indicate a problem with the testicles’ ability to produce sperm.

The Testing Process

Consultation with a Doctor

The first step is to schedule an appointment with a reproductive endocrinologist or a fertility specialist. The doctor will take a detailed medical history of both partners, including any previous pregnancies, surgeries, or medical conditions. They will also ask about lifestyle factors such as diet, exercise, and stress levels. For example, the doctor will ask about the woman’s menstrual cycle regularity and the man’s any history of testicular pain or swelling.

Sample Collection

For women, blood samples are usually taken for hormone testing. Ovulation testing may require daily urine samples or BBT charting at home. For men, a semen sample is collected. This is usually done by masturbation into a sterile container at the doctor’s office or a designated laboratory. The sample should be collected after a period of abstinence, usually 2 to 3 days, to ensure an accurate assessment of sperm quality.

Imaging and Other Tests

If recommended, women will undergo a pelvic ultrasound. This may be a transabdominal or transvaginal ultrasound, depending on the doctor’s preference and the patient’s situation. Men may also be referred for additional tests such as a testicular ultrasound if there are concerns about the testicles’ structure or function.

Interpretation of Results

Normal Results

If all the tests come back within the normal range, it is a good indication that there may not be any major fertility issues. However, it doesn’t guarantee immediate conception, as fertility is a complex process. The doctor may still recommend lifestyle modifications such as maintaining a healthy weight, reducing stress, and having regular intercourse around the time of ovulation.

Abnormal Results

If any of the tests show abnormal results, the doctor will discuss the implications with the couple or individual. For example, if a woman has a low ovarian reserve, the doctor may suggest options like fertility medications to stimulate ovulation or in vitro fertilization (IVF) in more severe cases. If a man has a low sperm count or poor sperm motility, treatment options could include lifestyle changes, medications to improve sperm quality, or assisted reproductive techniques such as intrauterine insemination (IUI).

Conclusion