How is Fertility Evaluation Done? A Step-by-Step Guide

There are many individuals and couples who desire to have children but are unable to due to fertility challenges. Infertility is quite common among both men and women. In order for people with infertility to find assistance in building their families, it is important for the cause of infertility to be determined. This is done in a process called fertility testing. This article will be discussing fertility evaluation, what it is, what it entails, how to prepare for such an evaluation and what the results could mean. 

What is a Fertility Evaluation?

A fertility evaluation is a process of determining the cause of infertility in a man or woman. It assesses reproductive health, hormone levels, ovarian reserve, sperm quality, and overall fertility potential. The purpose for this is that, by determining what the probable cause of infertility is, treatment options can be considered, as well, alternative methods for family building.

In order to become pregnant naturally it is vital to have regular unprotected sexual intercourse consistently. Within a few months of trying, most people will become pregnant. However, if after six to 12 months of trying pregnancy does not occur, it is recommended that fertility evaluation be considered.

Common Tests in a Fertility Evaluation

Fertility evaluations have a fairly straightforward approach which entail several medical tests. These are conducted for both men and women, particularly for heterosexual couples as the nature of their relationship allows them to try and build their families naturally. 

The nature of same-sex relationships leans toward different approaches to family building. However, the parties involved in LGBTQ+ family building plans may benefit from fertility evaluations should there be fertility challenges as well. 

Let us look at the tests that are typically conducted in a fertility evaluation below:

Blood Tests

Blood tests are used to evaluate the levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), inhibin and anti-mullerian hormone (AMH). FSH and LH regulate reproductive function in both men and women. 

Inhibin is a specialized type of hormone produced by males that helps to regulate FS in the body. AMH is a specialized type of hormone that is produced by females to stimulate the initial stages of antral follicle development. It is also key in determining the quantity of follicles left in the ovarian reserve.

Ultrasound and Imaging

Ultrasound and imaging is another evaluation that is done to quite literally, get a clearer picture of what is going on on the inside of reproductive organs. Imagery helps professional healthcare providers to see what the physical structure of the reproductive organs is, to detect any anomalies which could point to causes of infertility, as well as guide treatment plans that healthcare providers may consider.

Semen Analysis

A semen analysis is a test done specifically for men. It is used to determine the quantity and quality of sperm that a man produces. The quantity produced is evaluated in terms of the volume of semen produced in a single ejaculation as well as quantity of sperm produced within that ejaculation. This evaluation is more commonly referred to as sperm count.  

The quality of the sperm is evaluated in their form and how well they move. The form, shape or structure of sperm cells is referred to as sperm morphology. In this evaluation, the structure of the sperm cell is observed, to ensure that the sperm cell has all the necessary components for effective fertilization. While the shape of sperm cells may not necessarily indicate infertility, the shape may impact natural fertilization.

The movement, or motility, of sperm cells is evaluated in two aspects, general movement and forward movement. The ability of sperm to move at the basic level is important, but the ability to move forward is critical, because of the journey sperm must make from the vagina to the fallopian tube for fertilization, in natural conception.  

Genetic Testing

Perhaps the most crucial aspect of fertility evaluation is the genetic test. When it comes to genetic anomalies there are a variety of causes. They can be hereditary, as well, they can be as a result of prolonged illness or conditions, or even treatment.  

Anomalies in the DNA structures of either or both potential parents could lead to the improper formation of the embryo, or cause the embryo not to implant itself properly into the uterine wall, which could lead to miscarriage. This has been observed to be true particularly in cases where the potential parents experience repeated pregnancy loss (RPL).

How to Prepare for a Fertility Test

Diet and Lifestyle

When men or women are faced with fertility challenges, one assessment that professional healthcare providers use to understand the circumstances of infertility is through asking questions regarding sexual history, diet, and lifestyle. In some cases, it is these aspects that cause people to have difficulty in becoming pregnant. 

The least invasive treatment is making adjustments, and is often the first point of action. Therefore one may recommend changes in diet, getting more rest, managing stress and getting regular exercise. These have been found to not only impact a person’s overall wellbeing, they also have a positive impact on their reproductive systems. 

Fertility Testing

When there is no change after making lifestyle and diet adjustments, or the cause of infertility cannot be explained, the fertility evaluation would be the next step. As we have already seen there are several tests to expect at a fertility evaluation for both men and women. The professional healthcare provider will advise you on the tests they will be conducting. As well, they will share the necessary information on what to expect during each test. They will also advise you on how to prepare for each, and the order they will be conducted if any. 

Understanding Your Results

Once all the tests are conducted, the medical professional will go over the results with you. At this point, they will explain what each of the test results are, and what they mean. As well, they will share what negative test results may indicate as far as your fertility goes. It is at this point that they will advise on what options are available for treatment. At this point, they will typically address the benefits, risks, duration and cost of the treatment options. 

Summary

While it is true that infertility can present challenges for those who wish to build their families, reproductive medicine has come a very long way in seeking solutions. There are fertility challenges that can be treated or overcome, allowing people who wish to build their families to do so.  

If you are trying to  build your family, but are concerned that you may be experiencing infertility, contact San Diego Fertility. Our team of fertility experts are available to assist you in exploring what the cause could be. As well, walk with you through the journey to solutions and assisting you to achieve your family building goals. 

FAQs:

What is the purpose of a fertility evaluation?

The purpose of fertility evaluations is to identify potential causes of infertility for people struggling to conceive. The results guide doctors in recommending the most effective treatment options. 

How long does a fertility test take?

It depends on the test being conducted. Typically, blood tests will take a few minutes, ultrasounds or semen analysis may take 20 to 30 minutes. Checking for fallopian tube blockage (hysterosalpingogram (HSG)) could take up to an hour. While a comprehensive fertility evaluation which includes multiple tests, could take several days.

What tests are included in a fertility evaluation?

For women, tests include hormone tests, ultrasounds, a  hysterosalpingogram or sonohysterogram, and an antral follicle count. For men, the typical tests include semen analysis, hormone testing and DNA fragmentation tests. 

Can fertility evaluations predict my chances of getting pregnant?

No, they cannot. While they provide valuable medical information such as identifying causes of infertility and guiding decisions around treatment, there is no guarantee for pregnancy. As well, factors such as age, sperm quality and ovarian reserve contribute to overall fertility.

Does insurance cover fertility testing?

When it comes to fertility testing, insurance coverage varies based on provider and policy. Some  plans cover diagnostic fertility tests, while others may only cover testing if certain medical conditions are suspected. It may be best to check with your insurance provider, or consult a financial counselor at your fertility clinic to explore coverage options.