1. Investigating Infertility:When Should You Get Tested for Infertility?
Doctors recommend fertility testing if:
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A woman under 35 has been trying to conceive for 12 months without success.
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A woman over 35 has been trying for 6 months without success.
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A woman has irregular or absent menstrual cycles.
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A man has a history of low sperm count, erectile dysfunction, or hormone issues.
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A couple experiences multiple miscarriages.
The choice of tests depends on age, medical history, lifestyle, and suspected reproductive health conditions.
2. Investigating Infertility:Fertility Tests for Women
A. Hormonal Blood Tests
These tests assess ovarian reserve (egg supply), menstrual cycle regularity, and reproductive hormone balance:
Test Purpose Ideal Value for Fertility
Anti-Müllerian Hormone(AMH) Measures ovarian reserve 1.0–4.0 ng/mL
Follicle-Stimulating Hormone (FSH) Assesses ovarian function. <10 mIU/mL on day 3
Luteinizing Hormone (LH). Indicates ovulation issues. 5–20 mIU/mL on day 3
Estradiol (E2) Evaluates ovarian response. 25–75 pg/mL on day 3
Progesterone Confirms ovulation >3 ng/mL after ovulation
Prolactin Identifies hormonal imbalances 2–29 ng/mL
Thyroid Hormones (TSH & T4) Assesses thyroid function, which affects ovulation TSH: 0.4–4.0 mIU/L
These tests are usually done on specific days of the menstrual cycle to get the most accurate results.
B. Ultrasound Tests
Transvaginal Ultrasound helps evaluate:
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Antral Follicle Count (AFC) – Measures how many eggs are available for retrieval.
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Ovarian cysts or polycystic ovaries (PCOS).
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Fibroids or uterine abnormalities that can affect implantation.
C. Ovulation Tracking
Doctors may recommend tracking ovulation through:✔ Basal Body Temperature (BBT) charting – Slight increase in temperature after ovulation.✔ Ovulation predictor kits (OPKs) – Detects LH surge before ovulation.✔ Blood tests – Measures progesterone levels post-ovulation.
D. Fallopian Tube and Uterus Testing
1. Hysterosalpingography (HSG) – An X-ray test using contrast dye to check if fallopian tubes are open.
2. Sonohysterography – Uses ultrasound to detect polyps, fibroids, or uterine shape abnormalities.
3. Hysteroscopy – A small camera is inserted into the uterus to directly examine the endometrial lining.
If any blockages or abnormalities are found, surgical intervention may be needed to restore fertility.
3. Investigating Infertility:Fertility Tests for Men
A. Semen Analysis
A semen analysis evaluates:
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Sperm count – Normal is 15 million or more per milliliter.
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Sperm motility (movement) – At least 40% should be active.
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Sperm morphology (shape and size) – At least 4% normal shape.
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Volume – Normal is 1.5–5 mL per ejaculation.
B. Hormonal Tests
Men also need hormonal evaluations:
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Testosterone – Regulates sperm production (Normal: 300–1,000 ng/dL).
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FSH & LH – Stimulates sperm production (Normal: 1.5–12.4 mIU/mL).
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Prolactin – High levels may indicate pituitary dysfunction.
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Estradiol (E2) – Important for sperm maturation (Normal: 10–40 pg/mL).
C. Genetic Testing
If a man has severe sperm issues, genetic tests may identify Y-chromosome microdeletions or chromosomal abnormalities, such as Klinefelter Syndrome.
4. What Happens After Testing? Treatment Options
Based on the results, possible fertility treatments include:
A. Lifestyle Changes
✔ Maintaining a healthy weight.✔ Reducing alcohol, smoking, and caffeine.✔ Managing stress and sleep patterns.
B. Medications for Women
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Clomiphene citrate – Induces ovulation.
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Letrozole – Stimulates egg production.
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Gonadotropins (FSH, LH injections) – Used in IVF or IUI cycles.
C. Assisted Reproductive Technologies (ART)
1. Intrauterine Insemination (IUI) – Sperm is placed directly in the uterus.
2. In Vitro Fertilization (IVF) – Eggs are retrieved, fertilized, and implanted.
3. Intracytoplasmic Sperm Injection (ICSI) – A single sperm is injected into an egg, useful for male infertility.
4. Egg or sperm donation – If natural conception is not possible.
5. Conclusion: Investigating Infertility:The Importance of Early Testing
Early fertility testing can identify potential issues and help couples make informed decisions about their reproductive future.
Women should check their ovarian reserve by age 30 if planning to delay pregnancy.
Men should have a semen analysis if conception is unsuccessful after 12 months.
Advanced fertility treatments exist for many causes of infertility.
If you’re struggling to conceive, schedule a fertility evaluation today!
References
1. Cardim, H.J.P. Vencendo a Dificuldade de Engravidar. Editora Pensamento-Cultrix Ltda, 2009.