Whether you’re planning to start your family soon and want to understand your fertility status or you’ve been trying to conceive without success, having a fertility evaluation can improve your chance of getting pregnant.
A fertility evaluation is the next step if you’ve been trying to conceive without success for over a year (six months if you are over 35). Your OBGYN will perform a comprehensive assessment of your reproductive health so that you have a better idea of your chances of conceiving or if treatment may be necessary.
Fertility Evaluation Process
The fertility evaluation process consists of several steps. For couples struggling with infertility, both partners will need to be evaluated as there may be issues with either or both partners. Male partners will typically have their initial evaluation performed by a urologist.
- Initial Consultation: Your healthcare provider will discuss your medical history, lifestyle, and any previous pregnancies.
- Blood Tests: These tests check various hormone levels and may screen for certain infections that could affect fertility.
- Follicle-Stimulating Hormone (FSH): This test, usually performed on the second or third day of your menstrual cycle, measures the level of FSH, which is important for the development of eggs in women and sperm in men.
- Luteinizing Hormone (LH): LH plays a significant role in the menstrual cycle and ovulation. Like FSH, it’s typically measured early in the menstrual cycle.
- Estradiol: This form of estrogen is checked alongside FSH and LH to give a more comprehensive view of ovarian function.
- Progesterone: This hormone helps prepare the uterine lining for a fertilized egg to implant. A blood test usually conducted after ovulation can indicate whether ovulation has occurred and whether the levels are sufficient to support a pregnancy.
- Prolactin: High levels of prolactin can disrupt ovulation. This test is often performed if menstrual cycles are irregular.
- Thyroid Function Tests: Both hyperthyroidism and hypothyroidism can affect fertility. The thyroid-stimulating hormone (TSH) test is the most common method of evaluating thyroid function.
- Anti-Müllerian Hormone (AMH): This test indicates the ovarian reserve, or the number of remaining eggs, and can help in planning treatment strategies.
- Testosterone: Elevated testosterone levels in women can indicate conditions like polycystic ovary syndrome (PCOS) that may affect fertility.
- Infectious Disease Screening: Tests for sexually transmitted infections like HIV, hepatitis B and C, and syphilis may also be done, as these conditions can affect fertility and pregnancy.
- Blood Glucose and Insulin: For those with suspected or known insulin resistance or conditions like PCOS, tests to evaluate blood glucose and insulin levels may be performed.
- Ultrasound: This imaging method can assess the condition of the uterus, ovaries, and other reproductive organs.
- Ovulation Monitoring: Women are often asked to track their ovulation cycle to identify the most fertile days.
More advanced diagnostic tests, such as uterine biopsy, genetic testing, or laparoscopy, may be necessary in some cases.
Fertility Treatment Options
There’s a range of treatment options depending on the exact cause of infertility. Common treatments include:
- Lifestyle Changes: Subtle changes in your diet, physical activity, and stress levels can sometimes make a significant difference.
- Fertility Medications: Certain drugs can stimulate ovulation or improve other aspects of fertility, conception, and maintenance of the pregnancy. If any hormone levels are abnormal, medications can be given to correct the imbalances to help you conceive naturally or prepare for IVF.
- Intrauterine Insemination (IUI): This involves placing sperm directly into the uterus during ovulation to facilitate fertilization. This option may be helpful for mild sperm issues or women with certain cervical conditions.
- In Vitro Fertilization (IVF): In this procedure, eggs are harvested and fertilized with sperm outside the body. The embryo is then implanted into the uterus.
Costs and Insurance
Insurance coverage varies widely when it comes to fertility and advanced fertility treatments like IVF, so check with your insurance provider to see what may be covered. There are several financial assistance programs and payment plans available.Partner with an
Navigating fertility issues is rarely easy, but having an expert on your team helps. Partnering with an experienced, compassionate OB/GYN can improve your chance of conception and make you feel more comfortable during the process.