Thinking about starting a family and concerned about fertility? The process of evaluating fertility involves various tests, but not all of them are straightforward “pass or fail” evaluations. Most couples fall within a range of fertility, meaning it may be more challenging for some to conceive but not impossible. Fertility tests typically assess the reproductive health of both partners, focusing on factors such as sperm count, hormone levels, and anatomy. Let’s explore what these tests involve and what happens next.
**Getting Started**
The journey begins with a detailed interview and physical examination for both partners. This confidential and respectful conversation includes questions about sexual habits, the time spent trying to conceive, exposure to certain occupational risks, and lifestyle factors such as alcohol, nicotine, or drug use. Doctors may also ask about personal experiences with menstrual pain, past infections, erectile dysfunction, sexually transmitted diseases, medical procedures, and any medications. Honest communication during this step is essential to determine the right tests for your situation.
**Tests for Men**
Male fertility plays a role in about a third of infertility cases, making testing just as important for men as it is for women. A semen analysis is usually the first recommended test. This simple procedure evaluates sperm count, shape, and movement. Based on the results, men may be referred to a primary care physician or urologist for further examination.
**Tests for Women**
For women, several tests may be suggested after the initial interview:
– **Hormone and Thyroid Testing:** A blood test provides a baseline for hormone and thyroid levels. This helps check for issues that could disrupt ovulation or assess ovarian reserve.
– **Pelvic Ultrasound:** This test detects anatomical problems like polycystic ovary syndrome (PCOS) or other uterine irregularities. Sometimes a special X-ray (hysterosalpingogram) is recommended.
– **Hysteroscopy:** Doctors use a thin, lighted tube to examine the uterus and cervix for abnormalities.
– **Egg Count via Ultrasound:** Since women are born with a limited number of eggs, getting an ultrasound to estimate the remaining egg count can help plan for fertility treatments.
– **Hormone-Based Egg Count:** In addition to ultrasound, hormone tests through bloodwork can also provide a clearer picture of egg numbers.
**What Happens After Testing?**
Once all lab work and imaging tests are complete, a reproductive endocrinologist and infertility specialist (REI) may be recommended in certain cases. These situations include:
– Detecting abnormalities in the uterus or fallopian tubes
– A history of recurrent miscarriages
– Fertility planning for same-sex couples
– Preserving eggs or sperm for future fertility
For some couples, ovulation induction can be done through an OB-GYN’s care before seeing an REI. Ovulation induction involves taking medication at the start of a menstrual cycle, tracking ovulation through home kits, imaging, or hormone levels, and timing intercourse accordingly. Labs confirm if ovulation occurs, and if unsuccessful after three cycles, patients are typically referred to an infertility expert.
If you’re curious about fertility testing or need guidance, reach out to your healthcare provider to explore your options.