Fertility tests: what you need to know

For those who are struggling with conception, undergoing fertility testing can help uncover the root cause. In this article, a fertility specialist covers the different kinds of fertility tests.

Why would someone need to do fertility testing?

Infertility can be caused by many different things: medical conditions, genetic mutations, structural deformities, or even just hormonal instabilities.

Couples are recommended to undergo fertility testing:

if they are unable to conceive after a year of trying (for those under 35 years old)
if they are unable to conceive after six months of trying (for those over 35 years old)
if the menstrual cycle of the prospective mother is irregular

Fertility testing can also be sought out even before trying to conceive, if just to find out the state of the fertility of the mother or couple.

Fertility testing can be conducted in clinics, or they can be done at home, although the thoroughness and methods of tests will differ. Clinical testing will be facilitated by a fertility specialist, who will conduct a physical examination of both the prospective mother and father (when applicable).

The first step is a consultation which will include a review of the physical condition, menstrual cycle history, gynaecological medical history, prescriptions, sexual practices, diet and substance intake, and work environment. This helps to cover the wide range of possible factors that can influence fertility, like preexisting health conditions or exposure to toxins.

After the consultation, more thorough and specialised testing can take place. Some tests will differ between men and women.

General fertility tests can include:

Genetic testing to see if any mutations in the DNA could be causing fertility issues.
Chlamydia test, as this STI can suppress fertility.

Fertility tests for women may include:

Ovarian reserve testing, which is a combination of the blood test with a transvaginal ultrasound to count the antral follicles and measures the hormones produced in the ovaries to see if the egg production is regular for the patient’s age.
Blood tests, to check for hormonal imbalances that can alter the egg production and maturation cycle. The test results will show the levels of progesterone, oestradiol, thyroid-stimulating hormone, and prolactin.
Pelvic ultrasound (sonogram) or X-ray, to get a detailed scan of the uterus and check for structural obstructions to conception.
Hysteroscopy, where a scope with a light and camera at the end is inserted into the vagina to allow for a clear, high-res and in real colour look at the uterus and cervix.
AquaScan, which is employed when issues with the uterus or fallopian tubes is suspected to be the cause of infertility, such as endometriosis or fibroids.

Fertility tests for men may include:

Semen analysis, one of the most common tests that checks the quality (size, motility, and abnormality) and number of the sperm.
Blood tests, to check on the levels of the hormones that could be affecting the sperm such as testosterone, thyroid-stimulating hormone, luteinising hormone, prolactin, oestradiol, and follicle-stimulating hormone.
Testicular ultrasound, which will get a detailed scan of the scrotum and testicles for structural causes of infertility.

What happens after fertility testing?

After undergoing testing and getting the results back, the fertility specialist will sit down with the patient (or patients) to discuss the findings, their implications, and what the options are for conception going forward.

Even for results that are less than satisfactory, there are still interventions available that can allow hopeful mothers to conceive, such as in vitro fertilisation (IVF).

If you are struggling to conceive, consult with a fertility specialist on Top Doctors.