If you are under the age of 35 and have been regularly trying to conceive for over 12 months or you are over the age of 35 and you have been regularly trying to conceive for over six months, you may want to consider visiting a fertility specialist for an infertility workup.
A basic fertility workup is the first step to determine all the reasons a couple may be experiencing difficulty conceiving. While the unknown can be daunting and anxieties may run high when you are having trouble conceiving, identifying potential problems will empower you and your medical team to identify solutions. The following is a basic step-by-step guide to what you can expect when you schedule your first infertility workup.
During an initial consultation, your healthcare provider will ask detailed questions about your medical history that will relate to all medical and lifestyle factors that may contribute to infertility. After this consultation, the doctor will create a diagnostic plan that is tailored specifically for you. In this plan, your medical provider may seek to answer questions such as:
There are several standard tests that the female must typically go through during the work-up process:
The reason this is called three-day bloodwork is that a comprehensive blood draw is taken on the third day of your menstrual cycle to test several hormone levels. The blood work will look at the E2 (estrogen) level to determine if the main female reproductive hormone from the ovaries is being secreted normally. The bloodwork will also look at the level of FSH (Follicle-stimulating hormone), which is a chemical released from the brain that stimulates an ovary to mature an egg. Additionally, the bloodwork will look at the AMH (Anti-Müllerian hormone), which is the most accurate predictor of a woman’s egg supply. It does not vary from month-to-month, and it is not dependent on a woman’s menstrual cycle. Finally, the LH (luteinizing hormone) is measured, which is the hormone that releases a mature follicle.
Internal Baseline Ultrasound
The workup process will also include an ultrasound of the uterus, which is where embryos are implanted. The ultrasound will help determine if the woman’s uterus is normal and also take the antral follicle count, which is representative of the number of eggs available that particular month for a possible pregnancy.
The HSG test (hysterosalpingogram) is an x-ray of the uterus and Fallopian tubes. This test helps determine the condition of the uterus and see if the Fallopian tubes are open. It also looks to determine if there are any fibroids, polyps or scar tissue that could prevent pregnancy.
In 40-to-50 percent of couples struggling to conceive, the male partner has a condition that is causing or contributing to the couple’s infertility; therefore, it is important to analyze their sperm count and health. These tests are also much less intrusive than female infertility testing.
An andrologist will perform a semen analysis to evaluate the sperm’s potential to fertilize an egg. The number of sperm and whether they are normal — along with how well they swim — will be analyzed.
If you are considering fertility treatments, visit with us at Orange County Fertility Clinic. We would be happy to speak to you about the fertility process and your options. Call us at 949-528-8545 or visit us online today.