Whether you’ve just started to try for a baby or have been attempting to conceive for a while, understanding your fertility levels can feel overwhelming. That said, getting your fertility tested is not as complicated as you may believe. Thanks to modern medicine, there is a clear and actionable answer to all your doubts in these tests. But when exactly should you consider testing, and what does the process actually involve? Let’s break down everything you need to know about fertility testing for both women and men.
When should you consider fertility testing?
Before we delve deep into the tests themselves, it is important to first understand when you should get yourself a fertility test. Timing, after all, matters a lot here, and the recommendations that follow a test depend on your age and circumstances.
If you’re under the age of 35, your doctor will most likely recommend waiting for about 12 months of unprotected and regular intercourse before seeking a fertility test. But if you’re older than 35, the timeline then shrinks down to 6 months. That’s mainly due to how fertility naturally declines with age, and early intervention during this period can be a game-changer.
Beyond the age recommendations, there are always circumstances that could require a fertility test, regardless of how long you may have been trying. If you have irregular periods, a history of pelvic inflammatory disease, endometriosis, or previous cancer treatment, it makes sense to get a clearer picture of your fertility status from the start instead of waiting for the recommended time. To this end, it is always ideal to consult your choice of doctor to discuss the evaluations best for you and create a plan tailored to your medical history and goals.
What is fertility testing for women actually like?
When it comes to what a fertility test for women entails, there are three areas that doctors usually focus on: Your hormone levels, ovarian function, and the structural health of your reproductive organs. At the onset of tests, blood tests will be the first in line. Starting with your hormone levels, you’ll need to take tests like Anti-Müllerian Hormone (AMH) to gauge your egg reserve, Follicle Stimulating Hormone (FSH) and Luteinising Hormone (LH) to assess ovarian reserve and function, and progesterone to confirm ovulation.
Let’s talk about these tests in a bit more detail. So the role of an AMH test is to essentially determine the number of eggs available in your ovaries. This hormone is produced by small follicles in the ovaries, and its levels give doctors insight into how many eggs you have left. For women facing infertility, the range of this test is usually less than one, while the control group lies in the range of 1 to 3. All that is to say, the higher this number is, the better chances you have at conception. Once the doctors have assessed your reserves, they’ll need to regulate your menstrual cycle and ovulation. This is where FSH and LH come into play. This dual procedure begins on days 2 to 5 of your menstrual cycle, when hormone levels are at the base level. Here, the FSH test stimulates your ovaries to mature eggs. LH, on the other hand, simply triggers the process of ovulation. If your FSH levels come out elevated here, it simply means that your ovaries are working harder than normal to mature the eggs, which, once again, suggests that your ovarian reserve is on the lower end.
Finally, progesterone testing confirms whether or not you’re actually ovulating. This hormone rises after ovulation, so testing it about a week after your expected ovulation date lets the doctors know if an egg was released. This test also reveals whether you’re ovulating regularly or not.
In the situation where the blood tests are unable to reveal much, your doctor may move on to ultrasound scans. Pelvic ultrasound scans can create detailed images of your uterus and ovaries. But more importantly, these scans identify structural issues that may interfere with having a baby. These issues can be anything, from non-cancerous growths like fibroids, ovarian cysts, to small growths in the uterine lining called polyps. During the scans, your doctor will also count the number of small follicles in your ovaries. Counting these, when combined with the hormone tests above, can give an even clearer picture of your ovarian reserve.
Sometimes, these basic tests only reveal the need for more detailed investigation that requires special procedures. For instance, an aqua scan or saline hysteroscopy fills your uterus with a saline solution to get a clear view of your uterine lining and detect abnormalities that a standard ultrasound cannot show. Similarly, for checking your fallopian tubes, your doctor may recommend a hysterosalpingogram (HSG). This involves injecting a contrast dye through your cervix and taking X-rays to see if the dye was able to flow freely through your fallopian tubes. Blocked tubes can also prevent eggs and sperm from fusing together, so by the end of this test, your doctors should have an accurate idea of what’s causing your fertility issues. Of course, testing your partner matters just as much, so let’s jump over to the other side now.
What is fertility testing for men actually like?
Testing men for fertility-related issues is a lot more straightforward than testing women, but it is equally important. After all, male factors contribute to about 40% of fertility issues, so a comprehensive test should cover both partners. When it comes to men, semen analysis is the gold standard, which evaluates three aspects of sperm health.
First is the sperm count, which measures how many sperm are present in a sample (you need millions of sperm for good chances). After that, we have the motility test, which assesses how well the sperm can move and effectively reach the egg. Finally, morphology examines the sperm shape, as an abnormally shaped sperm may have difficulty penetrating the female egg.
These tests usually ask men to abstain from ejaculation for 2–3 days to get an accurate result. More importantly, since sperm production takes about 74 days, recent illnesses, stress, or lifestyle factors from the past few months will have an impact on the results. So be sure to communicate that to your healthcare professional before getting started.
What should be your next steps after a fertility test?
The result from all these fertility tests can be extremely overwhelming. But what these tests provide is deeper insights for your medical practitioner to further create a bespoke pregnancy plan.
It is important to remember that if your tests reveal any potential issue, do not take stress. Modern medicine offers a lot of treatment options that can make conception a success, from lifestyle modifications to advanced reproductive technologies. The key is to work with a doctor who can interpret your results correctly and develop a plan that sets you on your path to success.
In the end, it is important to remember that getting a fertility test doesn’t entail the same experience for everyone. The ups and downs that you may experience are a part of the process, and you must avoid the notion of giving up throughout it all. Remember: Your fertility story is unique – understanding where you stand today and planning things out is the first step in writing the next chapter of this tale.
