Fertility Testing
Fertility testing is the process by which fertility is assessed through laboratory tests, imaging tests, and certain procedures. Infertility tests can help identify the cause of infertility so that the condition can be treated appropriately, and the couple has the best chance of becoming pregnant.
What to expect
According to the American Society for Reproductive Medicine, infertility affects men and women equally, so both partners should be tested.
For Women
Ovaries
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Blood test: Day 3 FSH/E2 (Follicle Stimulating Hormone/Estradiol), AMH (Anti-Mullerian Hormone) – these hormone levels can be assessed to determine fertility status and future infertility treatment.
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Ultrasound: Antral Follicle Count test is performed by transvaginal ultrasound to count the number of follicles in each ovary. The more follicles there are, the greater the ovarian reserve.
*Follicles are the fluid filled sacs that contain an egg. The egg is too small to be seen by ultrasound and therefore we follow the follicles which grow as the egg matures.
Uterus and Fallopian tube
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HSG/SIS (Hysterosalpingograms/Saline Infusion Sonogram): these are tests to assess whether the fallopian tubes are open and to evaluate the uterine cavity.
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HSC (Hysteroscopy): A simple procedure that directly evaluates the uterine cavity by inserting a small camera into the uterus. If a polyp or fibroid is in the uterus, it can be removed from the lining of the uterus at the same time.
For Man
Semen Analysis is when we assess sperm quality by determining
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Volume of Semen - how much liquid comes out at ejaculation
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Sperm Concentration - how much sperm is in the liquid
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Motility - how many sperm are moving
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Morphology - how many sperm are normally shaped
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Sperm DNA Fragmentation - how many sperm have normal DNA
Who needs this?
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Infertility testing should be considered if couples have been actively trying to conceive through unprotected intercourse with their partner for more than a year and are still unable to conceive.
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If you are a female over the age of 35, fertility testing should be considered 6 months after trying to conceive.
Advantages
Knowledge is power. Knowing the cause of infertility will empower you to understand the reason for treatment. For the best experience and success, it is important to actively participate in your care with your fertility team.
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A reproductive fertility specialist can assess different factors and determine why the person is having fertility issues.
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The reliable and valid tests give you more information related to your fertility and suitable treatments.
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A specialist doctor will be able to provide you with comprehensive care and discuss what your next steps should be for treatments.
More info
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Additional testing may include female prenatal panel and Vitamin-D level.
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When using a third party to help build your family, FDA-required infectious disease screening is required.
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Fertility screening also includes a medical history and physical exam.
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Additional testing or appointments may be necessary based upon initial testing or evaluation results.
Q&A
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What is ovarian reserve?Ovarian reserve is the number of eggs left in the female. A woman makes all the eggs she will ever have before she is born, about 6 million eggs. Then at birth only 1 million is left because the eggs have already died. By puberty only 500,000 eggs are left. The egg count is constantly decreasing until menopause around age 52 when there are no more eggs left.
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What are fallopian tubes?Fallopian tubes are where the sperm and the egg meet. If the tubes are blocked, the eggs are on one side and the sperm on the other side. They cannot meet and pregnancy cannot occur.
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What is third party reproduction?Third party reproduction is when an outside person is involved to help build your family by either donating sperm, egg, or uterus to carry the pregnancy.
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How long does fertility testing take?Basic fertility testing for the woman will take 2 visits over 7-10 days at the beginning of the menstrual cycle.
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Is fertility testing covered by insurance?Some, but not all insurance cover fertility testing.
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Is it a painful process?Egg count testing is a vaginal ultrasound and blood draw. Patient’s experience minimal discomfort with both procedures. Uterine testing requires insertion of a catheter into the uterine cavity and the uterine cavity is distended with fluid. Insertion of the catheter and uterine distension can cause some cramping equivalent to menstrual cramping. Fallopian tube testing requires insertion of the catheter into the uterine cavity, distension of the uterus with fluid, then the filling and spilling of the fluid from the fallopian tubes. This procedure is usually quick with minimal pain if the fallopian tubes are open, but can also cause significant cramping and discomfort if the tubes are blocked.
