Fertility testing & diagnosis at a glance
- Fertility testing is used to determine the cause or causes of infertility in either partner, guiding our physicians to a diagnosis and treatment plan.
- Our fertility specialist will begin testing with a physical exam and health history discussion, followed by more specific tests such as hormonal blood work, imaging tests, semen analyses and more.
- For women under the age of 35, fertility testing is recommended after a year of unprotected intercourse with no pregnancy. For women 35 and older, it is recommended after six months. If a woman’s cycles are irregular, testing is recommended right away.
- Since male factor occurs in 35% of infertility cases, a man should be tested for infertility if his female partner is not getting pregnant or if his health history suggests his fertility may be compromised.
- We always prefer to evaluate the fertility of both partners whenever possible to more efficiently reach a diagnosis and treatment plan.
- There are very few risks associated with most fertility tests.
What is fertility testing?
Fertility testing encompasses a number of general and specialized tests, which help our fertility specialists identify the reason(s) for infertility.
According to the American Society for Reproductive Medicine (ASRM), individuals should seek medical help if they are unable to have a successful pregnancy after a year of unprotected sex, or sooner if over 35 years of age.
For couples dealing with infertility, it could be either partner. Male infertility is the major contributing factor in approximately 30% to 35% of cases. Female infertility and combined male and female factors account for the remainder, with the exception of 15%, which are diagnosed as unexplained infertility.
Our care philosophy on fertility testing
At Fertility Specialists Medical Group, we believe it is important to understand all the functional components of the reproductive process before recommending a plan of treatment. This means evaluating both partners whenever possible.
We look at sperm, eggs and the mechanics of getting those together (the uterus and the fallopian tubes). These are the areas where we are most likely to identify issues. By understanding the whole “system,” we can make the most appropriate and effective treatment recommendations for each couple or individual.
We may not perform every test on every patient. Our care philosophy is to provide tailored fertility care based on scientific evaluations; this includes what testing we perform. Some tests may be appropriate for some couples or individuals but not for others.
What types of fertility tests detect causes of infertility?
Our fertility specialist will begin with a physical exam and discuss the individual’s health and sexual history.
This can help the specialist narrow down the possible cause or causes of infertility.
Some questions in this initial conversation may include:
- What methods of birth control have been used?
- Is there a history of sexually transmitted infections (STIs) or diseases (STDs)?
- Do you or your partner use tobacco, alcohol or drugs?
- How often do you have sex?
- How long have you and your partner been trying to get pregnant?
At-home fertility tests
In recent years, there has been an increase in at-home fertility tests, including kits, devices and apps.
These tests claim to provide a full picture of a woman’s fertility at a lower cost than a fertility specialist. However, infertility is a complex diagnosis that may not have a single cause. An at-home fertility test that measures a certain hormone, may miss another aspect that is affecting fertility.
In general, home fertility testing is a nonspecific and nondiagnostic method of evaluating fertility. This means an individual will spend money on something that won’t really give complete answers – nor will these tests provide solutions.
At FSMG, we offer both!
Fertility tests for women
We can use various tests to diagnose female infertility problems.
Some of those tests include the following.
- Ovarian reserve tests like anti-Müllerian hormone (AMH) indirectly measure the quantity of eggs a woman has remaining compared with the quantity of other women her age.
- Hormone tests via a blood sample will examine the presence and amount of important hormones including estradiol, follicle-stimulating hormone, luteinizing hormone and more.
- Hysterosalpingogram (HSG) is an outpatient imaging test that checks to see if the fallopian tubes are open and anatomically normal in appearance.
- Hysteroscopy utilizes a small camera inserted through the cervix to view the inside of the uterus and evaluate it for causes of infertility.
- Laparoscopy allows a physician to view the fallopian tubes, ovaries and outside of the uterus through the use of a camera inserted through the abdomen.
- Saline infusion sonohysterography (SHG) is a specialized ultrasound used to detect uterine abnormalities like polyps, fibroids or Müllerian anomalies.
Most of the recommended testing for females can occur within approximately 4 weeks. If recommended, an HSG test or a sonohystogram must be performed at a specific time in the menstrual cycle. Most other testing is independent of the menstrual cycle and can be completed at a time that is convenient for the patient.
Male fertility tests
Male infertility is often determined by sperm characteristics.
Some tests that can help evaluate sperm or other factors impacting male fertility include:
- Semen analysis determines volume, motility (movement), morphology (shape) and sperm concentration (number). This test can also sometimes identify if there is an infection in the reproductive system.
- Blood hormone analysis can identify variances in hormone levels if sperm production is low. The hormones most important for reproduction are testosterone and follicle-stimulating hormone, among others.
- Ultrasound of internal organs or scrotum can identify anatomical problems associated with the male genital tract.
Most of male and female fertility tests, depending on the patients’ insurance, can be performed at a Fertility Specialists Medical Group location. However, some tests may be done at a radiology center or an outside laboratory.
Who should consider fertility testing?
- Women under 35 should seek evaluation for infertility after one year of trying to conceive.
- Women who are age 35-39 should seek evaluation after trying for six months.
- Those 40 and older should see a specialist after three months of trying to conceive.
- Women with known fertility problems, a history of irregular or painful periods, repeated miscarriages, endometriosis or pelvic inflammatory disease should present for evaluation as soon as possible if they desire to conceive.
- Individuals who have had cancer treatments, such as chemotherapy, pelvic radiation or ovarian surgery, should present for evaluation as soon as possible if they desire to conceive.
- Men who have a history of anatomical abnormalities or problems, such as undescended testicle or genital trauma.
What are the risks of fertility testing?
Very few risks are associated with tests like semen analysis, blood work or imaging exams.
Some tests such as laparoscopy, hysteroscopy and others associated with surgical procedures do have minimal risks. We thoroughly discuss these risks with patients before any tests are performed.