If you’ve been trying to conceive and it hasn’t happened yet, you may be wondering if you or your partner need the help of a fertility doctor or when you should take a fertility test. According to the American Society of Reproductive Medicine, you may consider seeking the advice of a fertility specialist if the female partner is under the age of 35, and the couple has been actively trying to conceive for at least one year; or if the female partner is over the age of 35 and the couple has actively been trying to conceive for at least six months without success.
However, you may want to consider making an appointment with a fertility specialist sooner if, as a woman, you:
- Have missed periods or experienced irregular periods
- Are concerned that you may not be ovulating
- Needed treatment for tubal damage or endometriosis
- Have been diagnosed with Polycystic Ovarian Syndrome (PCOS)
- Have a history of pelvic infection, such as pelvic inflammatory disease (PID) pelvic pain
- Have had two or more miscarriages (also known as Recurrent Pregnancy Loss)
If you have had two or more miscarriages, you may want to ask your doctor about when you should take a fertility test called Products Of Conception. It may provide an explanation for the pregnancy loss, but can only be performed if tissue can be collected during the miscarriage.
Women, Eggs and Age
Even if you’re not actively trying to conceive but you know you want to have children in the future, another factor to consider is age. A woman’s fertility starts to decline in her early 30s. With the decline speeding up after 35, being proactive about when you should take a fertility test and getting fertility advice may not be a bad idea. Women are born with approximately two million eggs. By their mid-twenties, women may only have 300,000 eggs. Then, around 35, the quality as well as the quantity begin to decline. As per the American Society of Reproductive Medicine, women under 30 have about a 25% chance of getting pregnant with each menstrual cycle when they are having regular unprotected intercourse. Women over 30 have a 20% chance, and by the time a woman turns 40 the chance is only 5%.
What Does a Fertility Test Entail
For women, there are two preliminary fertility tests. The first is blood work to look at various hormones such as your Follicle-stimulating hormone (FSH), Luteinizing hormone (LH), Oestradiol and your Anti-Müllerian Hormone (AMH). Your AMH in particular will provide insight into the amount of follicles you have in your ovaries (every follicle has an egg inside). These hormones will give the doctor an idea of how many eggs you have and a general idea of your reproductive health and ovulation function.
Men can go to either a reproductive endocrinologist or a urologist to have a semen analysis done. This entails producing a semen sample so that a doctor can look at three main factors: Sperm Count, Morphology (which is the shape of the sperm) and the Motility (which is how well the sperm swims). There are more advanced tests that can be done but this is typically the first fertility test for men, as well as some general blood work.
Women may also have a transvaginal sonogram. This is a procedure that evaluates the visual appearance of your uterus and ovaries. It could uncover ovarian cysts, endometrial inflammation, and provide additional information on your follicle count.
Putting All the Information Together
After these fertility tests are run, your doctor will review the results with you and if there are any concerns how to help address them. If something of concern is found, you will be presented with options for possible fertility treatments. This information can be difficult to digest, and may be distressing to hear. Stay connected to your partner and ask for support from family, friends and professionals along the way.
Reproductive Medicine is constantly evolving. New tests like the ERA test can help evaluate when a woman’s uterus is ready for embryo implantation and the best day to transfer the embryo. There is also Preimplantation genetic diagnosis (PGD) which can help identify known genetic conditions in your family you hope not to pass on. These are more advanced resources should you find you have a specific infertility issue or diagnosis but you should feel comfortable asking your doctor about if or when you should take either of these fertility tests.
Overall, fertility testing can be scary, but it may also give you information about your chances of becoming pregnant, and help identify treatments or tests that can help you achieve this dream. As they say; information is power and ideally, these tests can help provide insight to help you build your family!