Fertility Testing is done to evaluate the reasons for infertility in both the male and the female partner.
For women:
A detailed history will be taken about your pregnancy history and the outcome of those pregnancies as well your menstrual history.
There will be a physical examination and blood tests to check the levels of female hormones, thyroid hormones, prolactin and male hormones, as well as for HIV and hepatitis. The physical exam may include a pelvic examination to look for chlyamydia, gonorrhea or other genital infections that may contribute to the fertility problem.
Transvaginal (pelvic) ultrasound examination may be recommended. This checks the condition of the uterus and ovaries. If performed around 14 days before your period, it can often it can detect whether the follicles in the ovaries are working normally.
Hysterosalpinogram. Your doctor may also suggest a hysterosalpinogram, to check that your fallopian tubes are not blocked. If one of the tubes is blocked, the obstruction would be seen on the X-ray since the liquid dye won’t get past it.
Hysteroscopy. In this procedure, a thin telescope-like instrument is inserted through the cervix into the uterus to allow the doctor to see and photograph the area to look for problems if he/she suspects any abnormality in the uterus.
Laparoscopy. This is usually done to look for endometriosis, scarring, and other conditions. A slim tube with a light and camera is inserted through a very small incision. The procedure is done under general anesthesia and is usually done as a day surgery.
Not all women undergo all tests. Your doctor will guide you through those that are most appropriate for you.
For men:
A medical history and general physical examination will be completed. This includes questions about any chronic health problems, illnesses that could be inherited, injuries or surgeries that could affect fertility. In addition a discussion about your sexual habits and sexual development will give your doctor some baseline impressions. There will be a genital examination in addition to a general physical examination.
Semen analysis is done to measure the number of sperm present and look for any abnormalities in the shape (morphology) and movement (motility) of the sperm. The lab will also check your semen for signs of problems such as infections.
Several semen analysis tests are done over time to get an accurate result. This is because sperm counts fluctuate significantly from one specimen to the next.
There may be additional tests advised if required to identify the cause of your infertility such as:
Scrotal ultrasound. To identify a varicocele or other problems in the testicles or supporting structures.
Hormone testing. Hormones produced by the pituitary gland, hypothalamus and testicles play a key role in sexual development and sperm production.
Abnormalities in other hormonal or organ systems might also contribute to infertility. A blood test measures the level of testosterone and other hormones.
Genetic tests. A genetic cause could be the reason for infertility when sperm count is extremely low. Genetic testing might be ordered to diagnose various congenital or inherited syndromes.
Post-ejaculation urinalysis. Sperm in your urine can indicate your sperm are traveling backward into the bladder instead of out your penis during ejaculation (retrograde ejaculation).
Testicular biopsy. This test involves removing samples from the testicle with a needle. If the results of the testicular biopsy show that sperm production is normal your problem is likely caused by a blockage or another problem with sperm transport.
Frequently Asked Questions:
1. What’s the most common fertility issue for men and women?
The most common fertility problem for women is failure to ovulate. This occurs in about 40% of women with infertility problems. It often results from disorders such as PCOS, primary ovarian insufficiency, or hormonal imbalances. In men, the most common issues include low sperm count and abnormal sperm movement. These may be related to lifestyle, hormonal imbalances, or physical defects. Sometimes, no apparent reason for infertility is found in either of the spouses, known as unexplained infertility.
2. Are fertility tests painful?
Most fertility tests are not painful, though some can be slightly painful. For females, blood tests and ultrasounds are simple procedures. However, HSG (hysterosalpingography) to check on the fallopian tubes may cause cramping pains. For men, sperm analysis is quite simple and does not require an invasive procedure, only a semen sample. Invasive tests, such as biopsies, will cause a little pain; however, these are administered with anesthesia or pain control.
3. What hormones are tested for fertility?
Doctors check several hormones to understand fertility. For women, such tests include follicle-stimulating hormone (FSH), luteinizing hormone (LH), controlling the ovulation, as well as estradiol, anti-Müllerian hormone, and progesterone which help estimate the status of the ovarian reserve. Tests for men may include tests of testosterone and other hormones connected to sperm production. For everybody - both women and men- thyroid hormones, including prolactin, are estimated because thyroid functions or prolactin overactivity are also among the factors causing the failure of fertility.
4. When should you test for fertility?
The timing depends on the type of test. For women, tests like AMH can be done anytime, but FSH is best checked on the third day of your menstrual cycle. Ovulation tracking works best in the middle of your cycle. For men, there’s no specific timing; sperm analysis can be done anytime. If you’ve been trying to conceive for over a year (if the woman is less than 35 years old), it’s a good idea to start testing.
5. Which hormone confirms pregnancy?
Human chorionic gonadotropin (hCG) confirms pregnancy. The placenta makes this hormone after implantation. You can detect hCG in blood or urine within 10–14 days after conception. Its levels rise quickly during early pregnancy, which is why it’s the hormone measured in home pregnancy tests.
6. What shows how fertile you are?
Ovarian reserve in women is a strong marker of fertility. It can be tested through the AMH levels and antral follicle counts. Good fertility can be associated with regular ovulation and normal menstrual cycles. For men, the key markers for fertility are sperm health, count, movement, and shape. Generally, keeping oneself healthy plays a great role in fertility in both men and women. Apollo Fertility offers detailed evaluations and personalized care to help you on your journey to parenthood.
