Pregnancy may seem easy, but conceiving, at least for many couples, is very challenging. Many organ systems, of both male and female, must be in excellent shape and synchronized for conceiving successfully. A woman becomes pregnant only when a series of events happen in the correct order at the right time.
According to our panel gynaecologist Dr Ankita Patel Tayal , infertility is a reproductive disorder in males or females. A male or a female is said to be infertile if they fail to achieve a pregnancy after 12 months or more of unprotected sexual intercourse.
According to a source, 27.5 million couples encounter infertility (which makes around 10 to 15% of married couples). Many factors such as lifestyle changes contribute to difficulty in conceiving. In general, one-third of the reproductive problems are caused by female infertility. If you’re trying to become pregnant and things aren’t going as planned, you must be looking at the certain signs of ovulation and it might be a good time to think about fertility testing.
Fertility tests play a vital role in the evaluation and treatment of fertility. It is not only confined to females. On the other hand, it comprises fertility tests for females, fertility tests for males, and fertility tests for the couple. Using these tests, the doctor will be able to determine what makes getting pregnant challenging for a couple.
Female Fertility Tests- What Are They?
Fertility tests for females help identify the issues that stand between successful conception. Not all fertility tests are suitable for all couples facing difficulty in conception. Based on several factors, the doctor will decide which test to perform first.
Following are some of the steps involved in the fertility tests for females:
Calculate Due Date With Conception Date
1. Collecting medical history
This is the first step of the female fertility test. The doctor conducts basic physical exams and tries to get the medical history of the woman. This comprises:
- Her current health conditions
- Past pregnancy attempts
- Menstrual cycle issues
- Fertility treatment results (if conducted in the past)
2. Pelvic examination
This is done by putting in two lubricated gloved fingers to the vagina of the woman. During the pelvic exam, the doctor will be able to check the size and shape of the uterus and ovaries. The doctor will be able to detect if there are tender areas or unusual growths that need further investigation.
3. Blood tests for hormonal evaluation
Hormones play a vital role in getting pregnant and continuing pregnancy without any complications. So, lab tests before pregnancy are very important, especially if the woman experienced a miscarriage in the past.
Related Reading: How To Know If Your Period Is Coming Or You Are Pregnant
4. Nonsurgical evaluation of reproductive organs
Assessing the uterus, fallopian tube and ovaries is very important when it comes to fertility tests. The common non-surgical methods used for observing potential abnormalities in a woman’s reproductive organs are:
- Ultrasound
- Hysterosalpingogram (HSG)
- Sonohysterogram
5. Surgical evaluation of reproductive organs
Some problems that get in the way of conceiving can be detected only through a surgical evaluation. For example, endometriosis, uterine defects, and Fallopian tube damage. However, a surgical evaluation will be initiated only if all other tests fail to identify the underlying cause of difficulty to conceive.
Common surgical evaluations include
- Laparoscopy
- Hysteroscopy
When Should You Consider Going for A Fertility Test?
It may take up to a year to get pregnant, which is normal. But if you have been trying to conceive for more than a year and failed, it is best to discuss with a specialist about a fertility evaluation.
Experts recommend fertility evaluation:
- If you are not pregnant after 1 year of regular intercourse without taking contraceptive measures as there are lesser-known side effects of contraceptive pills
- If you are over 35 years old. In this case, the doctor recommends an evaluation if not get pregnant after trying regularly for 6 months without contraceptive measures
- If you are over 40 years old. In this case, the doctor recommends you take a fertility test before trying to become pregnant. Or, give you two months to try to get pregnant. If this does not work, don’t waste more time before taking a fertility assessment
There are ways to prepare your body for pregnancy after 30 years of age but by the age of 40, a woman’s chance of getting pregnant per menstrual cycle will drop below 10%.
Taking Fertility Tests Before Getting Pregnant- Who Should Go For It
Many factors affect women’s fertility. Age is an important factor. The fertility of men also declines with age, but not as much as women. In addition to age, if you still cannot get pregnant after a long period of trying,
- If experienced recurrent miscarriages
- Have a history of pelvic pain or endometriosis
- Have been diagnosed with issues of fallopian tubes, ovaries, or uterus
- Have a history of ectopic pregnancy
- Having heavy menstruation
- If the periods are irregular
- Absence of menstruation
- If detected with pelvic inflammatory disease
- Having thyroid problems
- If diagnosed with cystic fibrosis
Men with the following condition should consider fertility testing
- If have a family history of infertility
- Having hormonal issues
- Erectile dysfunction
- If he has a neurological condition
- If over aged
- Structural issues
- If underwent radiation therapy
Related Reading: 11 Foods That Should Be Avoided When Trying To Conceive
Important Fertility Test To Take Before Trying To Get Pregnant
Many fertility tests are very expensive. Not everyone needs to do all or most of these tests to find out the cause of infertility. Your doctor will decide which tests to perform and when based on the results of your main tests. You can decide to go with the doctor’s decision or not after considering if the cost is affordable or not.
The following are the main fertility tests you need to take before trying to conceive.
Fertility Tests for Females
Women’s fertility is dependent on a chain of factors like:
- Healthy ovaries that produce and release healthy eggs
- The reproductive tract that passes eggs safely into the Fallopian tube
- Healthy Fallopian tubes that allow the fertilization of sperm and egg and allow the fertilized egg to travel to the uterus
- A healthy uterus allows the fertilized egg to get implanted on its lining
If somewhere this chain of action is interrupted, fertility gets affected. Female infertility tests attempt to determine whether any of these mechanisms are compromised.
Female fertility tests can be broadly divided into:
- Lab tests
- Test for reproductive organs
Lab tests before pregnancy
Following are the important lab tests to take before trying to get pregnant:
Ovarian reserve testing
Aim: To find whether a woman can produce an egg or eggs of good quality. It also signifies how efficiently the ovaries respond to the hormonal signals from the brain.
When is conducted:
These tests are suggested if a woman is at high risk of ovarian reserve depletion. The risks include:
- According to the source ovarian reserve reduces progressively with age. Hence ovarian reserve testing is recommended for women in their late thirties
- Having only one ovary necessitate this test
- If the woman has a history of treatment with toxic agents (like chemotherapy)
- If diagnosed with unexplained infertility
- Having a family history of early menopause
Types of ovarian reserve testing conducted in a lab
- FSH testing: A blood test for follicle-stimulating hormone (FSH). It is usually conducted on the third day of the menstrual cycle
Cost: 290 INR
- AMH testing: The anti-Mullerian hormone test (AMH) is a blood test used to check a woman’s egg supply.
- Dr Ankita Patel Tayal, MD OBGYN, says that AMH has quickly become the ‘gold standard’ in fertility blood tests. Secreted by the small antral follicles in the ovary, AMH is present until a woman reaches menopause. Testing AMH gives a physician a good understanding of your ovarian function and egg reserve. Lower AMH levels can predict a lower egg yield and thus, a lower chance of success in patients undergoing IVF.
- AMH can be tested at any point in your menstrual cycle, and can also be done if you’re taking oral contraception.
Cost: 1000 INR
Types of hormone blood tests conducted before trying to get pregnant:
- Luteinizing hormone (LH) (290 INR) and progesterone tests (395 INR) are performed during the menstrual cycle. These tests make sure if the woman is ovulating
- Thyroid function tests (199 INR) may be done to check for thyroid hormone problems that may be preventing ovulation
- Prolactin is a hormone generated by the pituitary gland. Its level in the blood tells if a woman has a menstrual cycle or ovulation problems. Prolactin test(PRL) cost (290 INR)
- Androgen testing (340 INR) to evaluate androgen levels to check the possibility of the polycystic ovarian syndrome (PCOS), which is the most common cause of difficulty conceiving
- The estradiol test (425 INR) is conducted to find out how well the ovaries are working
Related Reading: Garlic And Fertility – How To Use The Herb For Best Results
Tests for reproductive organs
This can be further divided into imaging and surgical tests. Imaging tests will be not invasive or minimally invasive. Surgical tests, on the other hand, are surgeries performed to find/correct issues that hinder pregnancy.
Pap smear test
Why it is conducted: It is a non-invasive screening procedure that can detect changes in cervical cells. This test helps to detect cervical cancer, other cervical issues, or sexually transmitted diseases that can come in the way of conceiving.
Cost: 750 INR
Transvaginal ultrasound examination
Why it is conducted: It is a non-invasive way to examine a woman’s reproductive organs and helps diagnose anatomic problems like uterine fibroids and ovarian cysts.
Cost: 600 -800 INR
Hysterosalpingogram (HSG).
Why it is conducted: This is a nonsurgical test that helps detect possible uterine abnormalities, such as intrauterine adhesions, endometrial polyps, and uterine fibroids.
Cost: Around 2200 INR
Sonohysterogram
Why it is conducted: Sonohysterogram is a nonsurgical method used to see details inside the uterus that are not seen on a regular ultrasound. Abnormalities in a woman’s uterus are one of the primary causes of infertility.
Cost: 3000-4000 INR
Hysteroscopy
Why it is conducted: This minimally invasive surgical means of viewing, diagnosing, and if possible repairing polyps, scar tissues, uterine septa, and fibroids in the uterus
Cost: 40,000 INR
Laparoscopy
Why it is conducted: This minimally invasive surgery helps to identify problems with the ovaries and uterus. Laparoscopy helps to find out endometriosis, scarring, blockages or abnormalities of the fallopian tubes.
Cost: 20,000 to 50,000 INR
The antral follicle count
Why it is conducted: The antral follicle count is Ovarian reserve testing. This transvaginal ultrasound study helps to measures ovarian reserve.
Cost: NA
Endometrial Receptivity Test
Why it is conducted: This is not a part of a routine fertility test. This test is associated with IVF. Endometrial Receptivity Analysis (ERA), determines which day would be the best day to transfer the embryo during an IVF cycle.
Cost: INR 3500 and 7000
Related Reading: How Does Follicular Scan Help In Getting Pregnant?
Fertility tests for Males
Male fertility tests usually include a physical exam and a semen analysis.
Semen analysis
Why it is conducted:
A semen analysis looks at many factors. The four main factors evaluated are:
- Sperm count
- Motility of sperms
- Morphology of sperms (its shape, size, and quality)
- The quantity of seminal fluid
Cost of a semen analysis: Depending on the different parameters that are tested, the cost can range anywhere from 70 INR to 4000 INR.
Fertility tests for couples
Some fertility tests involve both partners. These tests include
Genetic karyotyping: This is usually done in case of recurrent miscarriage. This test looks for genetic disorders that may lead to miscarriage. This is done through a simple blood test.
Cost: 2850 INR
Post-coital testing (PCT): This is not a routine fertility test. PCT determines if the cervical mucus during the mid of the cycle (around the time ovulation happens) is favorable for sperm penetration. This is usually conducted several hours after the couple has sexual intercourse.
Cost: 238-400 INR
Conclusion
The process of determining the inability to conceive can take a toll on the couple- emotionally, financially, and even physically. Even then, performing fertility tests at the right time will help detect the infertility issue and correct it.