Getting pregnant is not always easy for everyone. Today, with an increase in awareness about fertility issues in both men and women, there are tests to help doctors identify the exact issue. What are these fertility tests, and do they differ for men and women? Are they accurate?
When a couple is unable to conceive naturally, it is necessary to analyse where the problem may lie. Fertility tests evaluate both partners for potential issues, which will enable fertility specialists start the appropriate treatments in time to increase the chances of conception.
Your fertility specialists will recommend fertility tests if –
● Both partners are under 35 years of age and are unable to conceive even after 1 full year of regular unprotected sexual intercourse.
● The female partner is over 35 years of age and has not conceived after 6 months of trying.
● The woman’s menstrual cycle is irregular.
After performing a pelvic examination to assess the reproductive organs, the fertility specialist will gather the following details to determine which fertility tests are needed.
● The female partner’s menstrual cycle history.
● Previous pregnancies, if any.
● Pregnancy attempts and their outcomes.
● Sexual life – history and frequency of sexual intercourse.
● Surgeries and long-term health history.
● Ongoing medications, if any.
● Consumption of alcohol and caffeine.
● Work environment to identify any ongoing exposure to chemicals, heat, radiation, or toxins.
● Past exposures to toxins or radiation, etc.
There is no single fertility test that can easily pinpoint the exact reason for infertility. Results from various tests conducted on both partners will be compared to narrow down the causes. Based on these causes, the next course of action will be recommended.
Trouble conceiving can be related to the male partner, the female partner, or sometimes both. It is necessary to evaluate both partners and check the results to identify the cause.
Gone are the days when fertility issues were assumed to be “a woman’s problem”. With more awareness and advancement in fertility medicine, doctors test both partners. For men, the fertility tests are limited to the sperm. Key fertility tests for men are –
● Semen Analysis - A semen analysis is a laboratory test that examines a man’s semen — the fluid released during ejaculation. This semen contains about 5% sperm, and the rest is seminal plasma. This sperm is extracted from the semen for further analysis. Sperm count, sperm motility, and shape. All three factors of the sperm are essential for pregnancy.
● Testicular Ultrasound – If there is an issue with the semen analysis, the doctor will next take an ultrasound of the testicles and scrotum to get a closer view of the internal structures and identify issues, if any.
● Advanced Sperm Testing - If the semen analysis is normal and shows nothing to worry about, the fertility specialist may decide to analyse the DNA of the sperm. Advanced sperm testing checks for DNA fragmentation in the sperm, which may be causing repeated miscarriages or failure of pregnancy attempts.
Unlike men, where fertility mainly depends on sperm health, female fertility is influenced by many different factors that affect both conception and pregnancy outcomes. Since she is the one carrying the baby throughout the pregnancy, her entire reproductive system needs to be evaluated to identify possible fertility issues.
The various tests to analyse a woman’s fertility are –
● Hormonal Blood Test - A blood test to check various hormones like the FSH, LH, and estradiol, to assess the egg quality and ovarian functioning. This test is usually done on day 3 or 4 of a woman’s menstrual cycle, when these hormones are at their peak, and the balance at this stage is important for understanding other issues.
● Anti-Müllerian Hormone (AMH) - A hormone test to determine the ovarian reserve. An AMH level below 1 indicates a poor egg reserve.
● Pelvic Ultrasound – An imaging test of the uterus and other reproductive organs to check for any issues. The scan checks for uterine fibroids, cysts, polyps, or scars that may interfere with pregnancy, and also measures the antral follicle count. This test also helps assess the possible response to IVF treatment.
● Thyroid and Prolactin Levels – A blood test to check the thyroid and prolactin levels. Very low or high thyroid or high prolactin can disrupt ovulation and pregnancy.
● HSG - Hysterosalpingography is an X-ray to check the fallopian tubes for blockages. It also checks for structural damage in the uterus, which could be leading to unsuccessful pregnancy attempts.
If you are planning to undergo fertility tests, here is what you can expect –
For a semen analysis, the man needs to provide a semen sample through ejaculation. To get accurate results, he’s usually advised to avoid ejaculation and sexual activity for at least 2 days before the test. The sample can be collected in a private room at the clinic or at home. If collected at home, it must be delivered to the lab within the time frame given by the clinic.
Along with gathering all previous medical records and test reports, the woman should start tracking her menstrual cycle. Certain hormone tests are usually done on day 3 or 4 of the cycle, so it’s important to inform the clinic as soon as her period begins. If an ultrasound requires a full bladder, she’ll be asked to drink enough water beforehand so the scan can be done properly.
Fertility tests are necessary and nothing to fear or be ashamed of. When a couple is unable to conceive, these fertility tests help identify the issue before it is too late. When the couple or individual undergoes the appropriate fertility treatment, the chances of pregnancy effectively increase.
Fertility evaluation is a diagnostic process that aims to assess a couple’s or an individual’s reproductive health. The tests identify or narrow down the reason for infertility, difficulty conceiving, or failed pregnancies. Based on these findings, the individual will be guided to the appropriate treatment.
If a couple actively trying to conceive is unable to conceive even after a whole year of unprotected sexual intercourse, they should consult a fertility specialist and undergo fertility testing.
Fertility tests for women include imaging tests to assess the reproductive system and hormone tests to check various hormone levels at different times of her menstrual cycle. Her ovulation is tracked to ensure she is ovulating regularly, and minimally invasive procedures like a hysteroscopy and laparoscopy are performed to check the internal structures of the reproductive system.
For men, the fertility test focuses on their sperm. A semen analysis will evaluate the quantity of ejaculated semen, the sperm count, sperm quality, motility, and shape. If everything seems alright in the semen analysis, an advanced sperm test can help identify DNA fragmentation in the sperm, which can also lead to fertility struggles.
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