Fertility testing is the next logical step when efforts to conceive are not successful.
Generally, if a woman has been trying unsuccessfully to conceive for one year and she is less than 35 years of age, she should make an appointment with a fertility specialist. If she is 35 years old or older, she should wait only six months before seeking help or being tested for fertility-related issues. If you are 40 years of age or older, time is even more of the essence.
There are many reasons why you may not be getting pregnant. Some of these reasons are simple or easy to overcome, including:
- Poor timing of intercourse as it relates to ovulation
- Stress contributing to erectile dysfunction
- Lifestyle factors such as smoking
More complicated fertility issues, however, require intervention from a reproductive endocrinologist, and begin with testing of both the male and the female.
The Fertility Testing Process for the Male
Fertility testing for a male begins with a basic semen analysis. An andrologist examines a sample of the male’s sperm to evaluate the sperm count, sperm motility, sperm morphology and other parameters like volume, PH, viscosity, viability, and agglutination. Also, the andrologist checks the sample for red and white blood cells.
Following semen analysis, if sperm parameters are compromised, the physician will ask for hormonal testing, which includes FSH, LH, prolactin, TSH and testosterone.
The Fertility Testing Process for Females
For a woman, the doctor will begin with hormonal testing to determine whether the patient is ovulating. The doctor will also ask for an Anti-Müllerian hormone blood test to assess her total ovarian reserve.
Usually the doctor will order a hysterosalpingogram, which is an x-ray of the uterus and the fallopian tubes, to evaluate tubal patency.
The doctor may also order an ultrasound of the uterine cavity to check for polyps or septum.
An irregular menstrual cycle may indicate polycystic ovarian syndrome, which contributes to infertility.
Endometriosis, depending on the stage, can also influence fertility.
If the semen parameters are within normal limits and if ovulation is occurring regularly and tubes are patent, then intra-uterine insemination (IUI) may be beneficial and cost-effective.
IUI involves the collection and processing of sperm and its injection directly into the uterine cavity.
How In Vitro Fertilization Bypasses Most Fertility Issues
IVF is useful in more complicated fertility issues. For example, in the male with azoospermia (no sperm found in the ejaculate), a testicular biopsy is performed by a urologist specializing in male infertility and sperm is taken directly from testicles.
Women with polyps, septum or tubal blockage can alternatively undergo surgery to repair these issues.
Intracytoplasmic sperm injection (ICSI) can also increase IVF success in situations where there is severe male factor with small numbers of sperm in the ejaculate.
Fertility testing addresses why you have not been able to conceive naturally. It helps clinicians formulate steps that will help you reach your pregnancy goals.
GENESIS has multiple office locations across metropolitan New York. Our winning team of clinicians assist patients in realizing their dream of becoming parents.