Female Fertility Tests
The following tests help us determine if you are ovulating, as well as your overall fertility potential.
Hormone Blood Tests
Day 3 Tests (tests that take place on the third day of your menstrual cycle)
Follicle Stimulating Hormone (FSH)
- FSH stimulates the growth of eggs during your menstrual cycle. As a woman ages and the number of eggs declines, FSH levels increase. Increased FSH levels), can indicate that you may have diminished ovarian reserve. When a woman does not get her menses and the levels of FSH are very low, this may be due to a problem with the function of the pituitary gland.
- E2 is the companion to FSH and is the ovaries’ method to communicate with the brain. E2 levels increase as an ovarian follicle becomes stimulated and is increasing in size. For evaluation and to ensure the validity of the FSH value, the estradiol level should be under 50 pg/ml. If it is elevated above 50 pg/ml early in the cycle, the ovaries are responding early, and egg quality is potentially decreased.
Luteinizing hormone (LH):
- LH tells the ovaries to release a mature egg. This process is called ovulation. High levels of LH could be a sign of a pituitary disorder or polycystic ovary syndrome (PCOS) Low levels of LH may be a sign of a pituitary disorder or a hypothalamic problem and can be observed in women with an eating disorder, over-exercising, or high stress levels.
Anti-Mullerian Hormone (AMH)
AMH blood testing can take place at any point during the menstrual cycle. AMH is the most sensitive hormone marker of fertility potential. It is produced by the granulosa cells which surround and support the early developing eggs in the ovaries. Over a lifetime, as the number of eggs decreases, the granulosa cells decrease and AMH levels decrease. In combination with an antral follicle ultrasound, it provides a reasonable estimate of ovarian reserve (number of eggs remaining in the ovaries). The AMH level also predicts the response of the ovaries to injectable fertility medications and will assist your physician in customizing your treatment protocol for IVF.
A transvaginal ultrasound allows us to assess resting/antral follicle count (AFC). The ultrasound usually takes place between days three to twelve of your period and is performed by counting the total number of follicles between four and nine millimeters in both ovaries. These are eggs which could potentially mature and be ovulated. A smaller number of follicles means you may have problems with egg quality and quantity.
Find your local CCRM Fertility clinic to schedule a fertility test.
Additional Testing to Evaluate Female Fertility
An x-ray procedure during which dye is introduced into the uterus through the cervix and passed through the fallopian tubes.
A thin, lighted tube is inserted into the vagina to examine the cervix and inside of the uterus.
A fiber-optic instrument is inserted through a small incision in abdominal wall to view the organs in the abdomen.
Saline infusion sonohysterography (SIS)
A sterile saline solution is infused into the uterine cavity through a small catheter at the same time. By distending the uterine cavity with the saline solution, visualization is significantly enhanced.
Male Fertility Tests
The following tests evaluate your sperm count and the overall health of your sperm.
Assessing male fertility is a simple process that requires complex evaluation. Through a semen analysis, we can assess whether there is a problem present by evaluating the following parameters:
- Concentration This refers to the quantity or number of sperm in your ejaculate. When the concentration of sperm is low (referred to as oligozoospermia), the chance that the sperm will reach an egg in the woman’s fallopian tubes is greatly reduced. When there is a complete absence of sperm (“no sperm count”), this is known as azoospermia. Greater than 15 million sperm per milliliter is considered normal.
- Motility/Movement: Sperm must successfully swim through a woman’s cervix, uterus and fallopian tubes to meet up with, and hopefully fertilize, an egg. The numbers of sperm that move and how they move are both important factors. For instance, some sperm might move, but only in circles or in zigzags. Others might vibrate, but not make any forward progression. Poor sperm motility is also known as asthenozoospermia. If more than 32% of your sperm are moving, your motility is considered normal.
- Morphology: Healthy sperm have smooth, oval-shaped heads and long tails, which help to propel them as they swim. Sperm with abnormal morphology are less likely to reach, puncture, or enter the egg’s membrane. Having a large number of abnormally formed sperm are signs of a condition called teratozoospermia. Normal results are when 14% or more of the sperm have normal shaped heads, according to the Kruger morphology test. When sperm have a morphology below 9%, the risk of infertility increases by 2.9 times.
Additional assessments of sperm include the antisperm antibody test, sperm DNA fragmentation analysis, culture of semen for infections, binding studies, penetration assays, and several other methods to assess male fertility.
If you are interested in fertility testing, please contact us today to schedule an appointment.