Fertility Testings for Women

When to Consider Fertility Testing

Some individuals become pregnant quickly, while others may take longer. If you haven't conceived after over a year of trying, you should see the doctor. Women over the age of 36 years, as well as anyone who suspects they may have problems with fertility, should consult their doctor as soon as possible.

In addition to this, women with the conditions listed below should consider fertility testing:

• Diagnosed reproductive issues in the ovaries, uterus, or fallopian tubes, including irregular, heavy, or absent periods.
• Repeated miscarriages.
• History of pelvic pain, endometriosis, or pelvic inflammatory disease
• Partner with uncertain or diagnosed male infertility.

Fertility Tests for Women

The initial stage to checking fertility in woman involves a consultation with a fertility doctor. This session will include an in-depth discussion of your past health conditions and lifestyle. Topics will cover use of birth control, menstruation and history of pregnancy, past and present sexual behaviours, surgical history, medications used, other medical conditions, and your lifestyle/working environment.

A full physical examination, including a pelvic exam, will be performed.

Following this first consultation, your doctor may wish to perform some preliminary fertility tests for women. This initial testing will determine ovarian reserve testing, confirm if and when ovulation is occurring, and evaluate the uterine and ovarian functioning during the ovulation cycle.

Ovarian Reserve Testing

Ovarian reserve screening is an important part of checking fertility in woman. These tests evaluate both the quality and quantity of a woman's eggs, which can have a direct impact on her ability to get pregnant. Following are some of the common tests involved during ovarian reserve testing:

• Follicle-Stimulating Hormone (FSH) test: FSH is a hormone that stimulates the formation of ovarian follicles. High levels of FSH may indicate a low ovarian reserve.
• Anti-Mullerian Hormone (AMH) test: AMH is a hormone released by growing follicles in the ovaries. Lower AMH levels may indicate a reduced ovarian reserve.
• Antral Follicle Count (AFC): This is a vaginal ultrasound scan that determines the amount of resting follicles in the ovaries. A lower AFC could indicate a decreased ovarian reserve.

Ovulation Assessment

Ovulation fertility tests for women can be grouped into the following:

Ovulation testing 

This involves checking your basal body temperature charts and utilizing ovulation prediction kits, blood tests, and ultrasound, to determine whether or not ovulation is taking place.

Ovarian function testing

These tests look at the way the hormones in your body function and work during the ovulation cycle. Tests include performing follicle stimulating hormone (FSH) on day 3, oestradiol (oestrogen) on day 3, ultrasound (to verify ovulation), and blood tests to assess inhibin B levels.

Luteal Phase testing 

This will include progesterone levels, further hormone tests, and perhaps an endometrial biopsy.

Hormone testing

The majority of this testing will focus on comprehensive hormone tests.

The hormone evaluation and fertility tests for women include the following:

• Follicle stimulating hormone
• Luteinizing hormone
• Progesterone
• Prolactin
• Oestradiol 
• Total testosterone
• Free testosterone
• Free T3
• Androstenedione
• DHEAS

Additional Fertility Tests for Females in the Initial Evaluation Cycle

Following are some of the additional tests that are often performed in the initial evaluation cycle:

• Cervical mucus tests: This consists of a post coital test that assesses if sperm can enter and thrive in the woman’s cervical mucus. It also includes bacterial screening.
• Vaginal ultrasound: These are used to determine the uterine lining (endometrium) thickness, track follicle growth, and assess the ovaries and uterus condition. An ultrasound can be performed between two and three days after to ensure whether an egg/ova has been successfully discharged.

If the above-mentioned tests along with the semen analysis show normal findings, your fertility doctor may prescribe additional testing. These tests can involve:

Hysterosalpingogram (HSG):

An X-ray image of the fallopian tubes and uterus. Via the cervix, a dye is administered into the fallopian tubes and uterus, allowing the radiologist to determine whether there is an obstruction or another issue.

Hysteroscopy:

This procedure may be utilized if an HSG shows  evidence of any abnormalities. For this procedure, the hysteroscope is passed into the uterus via the cervix, allowing your fertility expert to examine any abnormalities or growths. The hysteroscope enables the doctor to take images that can be retained for future analysis.

Diagnostic laparoscopy:

A procedure typically performed under general anaesthesia using a thin fibre-optic telescope. A laparoscope is advanced into a woman's abdomen to allow a view of her uterus, ovaries, and fallopian tubes. A laser can remove any abnormalities identified, such as adhesions, endometriosis, or scar tissue. It is crucial to note that before doing this test, you must verify whether or not you are pregnant. This test cannot be done if you are pregnant.

Endometrial biopsy:

It is a procedure that involves scraping only a small portion of tissue material from the uterine lining shortly before menstruation. This method is used to test whether the lining is sufficiently thick to allow an egg that has been fertilized to implant and develop. Before doing this test, you need to ensure that you aren't pregnant.

It is important to note that not all women need to undergo these tests, and your doctor will know which ones to recommend based on your specific condition.

Takeaway

Female infertility can be a difficult and stressful experience; however, by determining the root cause of the fertility problem, women can take an informed next step. If you are somebody facing issues conceiving, it is worth taking a consultation with a fertility expert and undertaking appropriate fertility tests for women recommended by your doctor as your first steps towards overcoming infertility.