Infertility testing involves a series of screenings, assessments, and lab tests that provide valuable information, specifically geared towards analyzing the health of your reproductive organs. This ranges from non-invasive procedures, like a thorough review of your family and personal medical/reproductive history, to more invasive procedures that evaluate potential blockages or malformations in the fallopian tubes and uterus.
As OB/GYNs, we can perform the first round of fertility tests used to identify some of the most common causes of female infertility. We’ll discuss those in more detail below. If, however, our tests do not yield answers, we’ll refer you to a fertility specialist for more specific testing and diagnosis.
When Should I Worry About Infertility?
Most fertility couples who try to get pregnant each month, timing intercourse with the woman’s fertile window, will get pregnant within a calendar year. Not exactly sure about your fertile window? Read Parent Magazine’s article, How to Find Your Fertility Window When Trying to Conceive.
When you’re ready to get pregnant, we highly recommend scheduling a preconception appointment with your OB/GYN. In most cases, couples should seek fertility testing if you are:
- Younger than 36 years of age and has been trying for 12 consecutive months
- 37 years old or more and has been trying consecutively for 6 months
- 40 years old or older and have tried for three cycles.
Fertility is directly linked to age for both men and women (yes, males have a biological clock, too!). However, maternal age is one of the most important factors when you seek fertility treatment when you’re 36 years or older as egg quality diminishes with every year.
Accurate Infertility Diagnosis Relies on a Complete Infertility Workup
While the amount of tests and appointments required to complete your infertility workup can seem excessive, we assure you that every step is essential. Some couples have multiple infertility factors working against their ability to conceive, and it is only through complete infertility testing that we can create a personalized fertility treatment plan.
In addition to the more general aspects of infertility testing – like routine blood panels, urine tests, and a complete physical – there is a standard roster of imaging and diagnostic tests we use to get a detailed sense of your reproductive tract.
Make sure your partner has his sperm analyzed
Women are only half of the fertility equation, and the data shows that roughly half of infertility diagnoses involve issues with sperm count, motility (how they move), and morphology (how sperm are shaped). If you and your partner are struggling to conceive, both of you should schedule appointments.
You’ll begin at your OB/GYN’s office and he should schedule an appointment with a urologist to provide a semen sample and to complete a fertility-oriented physical and review of his medical history.
At-Home LH test
To make sure you are ovulating, use an at-home LH (luteinizing hormone) test. Also known as an ovulation prediction kit (OPK), you can buy them at your local drug store. Once you are familiar with your average cycle length, follow the instructions on the OPK test to ensure you’re actually ovulating.
We can use both pelvic and vaginal ultrasounds to get a better look at your reproductive tract, honing in on your ovaries, fallopian tubes and uterus. This can reveal things like scarring or endometriosis, certain anatomical abnormalities, as well as fibroid tumors or the notorious “string of pearls,” which is a sign of polycystic ovarian syndrome (PCOS), one of the leading causes of female infertility in the United States.
Hormone and AMH Testing
As part of your routine blood work, we’ll also want to evaluate your hormone levels to make sure estrogen, progesterone, and testosterone are balanced. We’ll also look at your AMH (anti-mullerian hormone) levels. Low AMH levels can indicate that you have a low ovarian reserve or may be in early menopause; numbers above the normal range are a sure sign of PCOS.
If you have a history of endometriosis, or if your physical or symptoms reveal a potential for endometriosis, we may perform a laparoscopy. This scope is designed to get an internal view of your anatomy, using a scope with a camera. We insert it into your vagina and cervix. If we notice endometrial tissue where it shouldn’t be, the scope is equipped with a small blade that we use to remove the tissue or suspicious growths if we feel it is safe to do so.
Based on the results, we may recommend additional treatments or we may give you a referral to a fertility specialist for more testing and analysis.
Are you worried you aren’t getting pregnant as easily as you should? Schedule an appointment with us here at OB/GYN Associates of Spokane.