Thinking about having a baby can bring excitement — and a lot of questions. Whether thinking about having a baby soon, someday or just curious about your fertility, you might wonder, “Is everything working the way it should?”
That’s where fertility testing comes in. Fertility testing helps identify what could be standing in the way of getting pregnant. It’s for everyone, not just couples struggling to conceive (get pregnant).
We spoke with two fertility experts to better understand fertility testing and what to expect.
Fertility testing starts with your health
If you’re thinking about having a baby – now or down the road – the first step is to schedule a preconception appointment. This is a check-up with a health care provider specializing in reproductive health.
“During a preconception visit, your provider can screen for any potential hurdles in fertility as well as any steps that may better prepare you for pregnancy,” said Taylor Norton, MD, a minimally invasive gynecologic surgeon with Banner – University Medicine.
The provider will review your medical and sexual history, menstrual cycle (periods), medications, lifestyle habits and more. They may recommend starting a prenatal vitamin, checking your weight or managing conditions like diabetes or thyroid disease.
“General health is always the most important factor,” said Priyanka Bearelly, MD, a urologist and andrology specialist with Banner – University Medicine. “So if you haven’t had a routine wellness check in a while, this would be the time.”
What causes infertility?
Infertility (the inability to conceive) is more common than many people realize. It affects about one in eight couples.
Female infertility challenges
For women, infertility can have many causes. According to Dr. Norton, some common reasons include:
- Structural problems like blocked fallopian tubes or unusual anatomy
- Hormonal issues like irregular or absent ovulation, often seen in conditions such as polycystic ovary syndrome (PCOS)
- Medical conditions like endometriosis, thyroid disease, obesity and diabetes
- Age-related decline in egg number and quality
To find the cause, your provider may recommend several tests:
- Hormone level testing: Blood tests to measure hormones involved in ovulation and egg supply, including follicle-stimulating hormone (FSH), luteinizing hormone (LH) and anti-Müllerian hormone (AMH). FSH and LH stimulate follicle growth and development in the ovaries, while AMH is a marker of ovarian reserve (number of remaining eggs in the ovaries).
- Pelvic or transvaginal ultrasound: Imaging tests to identify structural issues in your ovaries or uterus.
- Hysterosalpingogram: A special type of X-ray that checks whether your uterus and fallopian tubes are open or blocked.
- Egg count testing: Also called ovarian reserve testing, may include a blood test or ultrasound to estimate your egg supply.
Male infertility challenges
Fertility issues in men often go unnoticed until a couple starts trying to get pregnant. But they’re just as important to explore.
“Male factor fertility plays a role in a couple’s infertility 50% of the time,” Dr. Bearelly said. “If a couple has been unsuccessful in trying to conceive for six to 12 months, then it’s a good time for the male partner to undergo evaluation and at least start with a semen analysis.”
A semen analysis looks at sperm count, shape of the sperm and movement of the sperm.
- Low sperm count or poor sperm quality can be caused by:
- Lifestyle habits like poor diet, smoking, lack of exercise or substance use
- Heat exposure (hot tubs, saunas)
- Hormonal imbalances like low testosterone
- Varicoceles (swollen veins in the scrotum)
- Genetic conditions
[Learn more about male fertility and how to improve your reproductive health.]
When should I see a fertility specialist?
“During your preconception visit, you’ll discuss any conditions or issues that may require more advanced evaluation and/or treatment,” Dr. Norton said. “At that time, you may be referred to a reproductive endocrinologist and infertility specialist (REI).”
You may need to see a specialist if:
- You’re under 35 and haven’t gotten pregnant after 12 months of trying
- You’re over 35 and haven’t conceived after six months
- You’ve had multiple miscarriages
- You or your partner has a known medical issue that affects fertility
How is infertility treated?
Fertility treatment depends on the cause of infertility, age and other health factors. Some people get pregnant with lifestyle changes or medication. Others may need surgery or assisted reproductive technology (ART).
1. Lifestyle changes
Improving your overall health can make a big difference, especially in men. “Any change that can improve your overall health will inevitably translate into improved sperm quality,” Dr. Bearelly said.
This includes:
- Quitting smoking
- Eating a healthy diet
- Exercising regularly
- Reducing heat exposure to the testicles
2. Medications
Health care specialists can prescribe medications to:
- Help women ovulate regularly
- Balance hormone levels
- Support sperm production in men
Ovulation medications are often used early in treatment, either alone or with timed intercourse (sex).
3. Surgery
Surgery may be needed to correct physical problems that affect fertility. “In my role as a minimally invasive gynecologic surgeon, we may use surgery as an additional tool to evaluate and treat some causes of fertility,” Dr. Norton said.
Common procedures include:
- Laparoscopy to remove endometriosis or scar tissue
- Hysteroscopy to remove fibroids or polyps in the uterus
- Tubal re-anastomosis, also known as tubal ligation, to unblock the fallopian tubes
- Varicocele repair to improve sperm production
- Sperm retrieval surgery when sperm are not present in the semen
4. Assisted Reproductive Technologies (ART)
If medications and surgery aren’t enough, ART can help you conceive. These include:
- IUI (intrauterine insemination): Sperm is placed directly into the uterus at the time of ovulation.
- IVF (in vitro fertilization): Eggs are fertilized outside the body, and one or more embryos are placed in the uterus.
- ICSI (intracytoplasmic sperm injection): A single sperm is injected directly into an egg, often used for male infertility.
- Egg or sperm donation: Used when fertility is low or absent due to age, health conditions or genetics.
- Gestational carriers (surrogates): Sometimes used when carrying a pregnancy is not possible.
Takeaway
Pregnancy – whether soon or in the future – can feel overwhelming, but you don’t have to figure it out on your own. A preconception visit is the best place to start.
If you’re concerned about your fertility, talk to your health care provider or a Banner Health reproductive specialist. They can guide you through the testing process, answer your questions and support you every step of the way.