Fertility Testing

Fertility Testing – A Comprehensive Guide to Assessing Your Reproductive Health

Fertility testing is really helpful in situations where difficulty in conceiving is an issue. These tests are conducted on both the partners to uncover potential issues like hormonal imbalances, ovulation problems, or sperm health concerns.

For women, tests focus on hormone levels, ovulation, and reproductive health. For men, they examine sperm count, quality, and movement. Understanding these results helps pinpoint the cause and guide you toward the right treatment options.

With the right plan in place, fertility testing can bring you closer to making your dream of parenthood a reality.

Tests Included in Fertility Testing

Fertility testing typically involves several tests to evaluate both male and female reproductive health. Below, we cover the most common tests, their normal and abnormal ranges, what each test signifies, and possible management options.

1. Hormone Tests (For Women)

These tests measure the levels of various hormones related to reproduction. Hormonal imbalances are a common cause of infertility in women.

● Follicle-Stimulating Hormone (FSH): This hormone helps control the menstrual cycle and stimulates the growth of eggs in the ovaries.

● Normal Range: 3–10 mIU/mL (varies depending on the menstrual phase).

● Abnormal Range: Elevated FSH levels may indicate reduced ovarian reserve or ovarian dysfunction.

● What It Signifies: High FSH levels can signal premature ovarian failure or diminished ovarian reserve, meaning fewer eggs are available for fertilization. Low levels may indicate hypothalamic or pituitary dysfunction.

● Management: If elevated, treatment options may include ovarian stimulation with fertility medications or egg donation. For low levels, treatments might include hormone therapy to stimulate ovulation.

● Luteinizing Hormone (LH): LH triggers ovulation and is crucial for the menstrual cycle.

● Normal Range: 5–20 mIU/mL during the follicular phase and 10–40 mIU/mL around ovulation.

● Abnormal Range: High LH levels can indicate polycystic ovary syndrome (PCOS), while low LH levels may indicate pituitary problems.

● What It Signifies: An LH to FSH ratio that is higher than 2:1 is commonly seen in PCOS, a condition that can lead to irregular ovulation or anovulation (lack of ovulation).

● Management: In cases of PCOS, treatment options may include clomiphene citrate (Clomid) to stimulate ovulation or lifestyle changes such as weight loss and insulin-sensitizing drugs.

● Estradiol (E2): This is the primary form of estrogen, which plays a key role in regulating the menstrual cycle and preparing the uterus for pregnancy.

● Normal Range: 30–400 pg/mL during the follicular phase; levels rise during ovulation and decrease after.

● Abnormal Range: Low estradiol levels may indicate poor ovarian reserve or early menopause.

● What It Signifies: Low estradiol levels may suggest an insufficient amount of healthy eggs in the ovaries or anovulation.

● Management: Estradiol therapy or fertility medications like gonadotropins may help regulate ovulation.

2. Ovulation Tracking (For Women)

Tracking ovulation can help determine if and when a woman is ovulating, which is essential for successful conception.

● Basal Body Temperature (BBT) Charting: This test involves tracking daily body temperature using a basal thermometer. A rise in temperature indicates ovulation.

● Normal Range: A consistent rise in body temperature after ovulation, usually by 0.5°F–1°F.

● Abnormal Range: A lack of temperature increase may indicate anovulation.

● What It Signifies: Irregular or absent ovulation may suggest hormonal imbalances, ovarian problems, or issues with the hypothalamus or pituitary gland.

● Management: Ovulation induction therapy may be recommended, including clomiphene citrate or gonadotropins, to trigger ovulation.

● Transvaginal Ultrasound (TVS): An ultrasound can be used to monitor the development of follicles in the ovaries and check the endometrial lining for thickness.

● Normal Range: Multiple follicles developing in both ovaries, with the largest follicle reaching 18–24 mm before ovulation.

● Abnormal Range: The absence of follicle development or follicles that are too small can indicate issues like ovarian dysfunction.

● What It Signifies: An absence of developing follicles may suggest ovulatory dysfunction or anovulation.

● Management: Ovarian stimulation can be done to induce follicular development.

3. Hysterosalpingography (HSG) – Uterine and Fallopian Tube Assessment

HSG is a test where a dye is injected into the uterus, and X-rays are taken to check the health of the uterus and fallopian tubes.

● Normal Range: A clear passage of dye through both fallopian tubes with no blockages.

● Abnormal Range: Blocked fallopian tubes or uterine abnormalities (like fibroids or polyps) may show up on the X-ray.

● What It Signifies: Blocked fallopian tubes can prevent eggs from reaching the uterus, causing infertility. Abnormalities in the uterus may hinder implantation.

● Management: Blockages may be treated with laparoscopy or surgical intervention to remove obstructions. Uterine abnormalities may require surgery or hysteroscopy to remove fibroids or polyps.

4. Semen Analysis (For Men)

A semen analysis tests sperm count, motility, and morphology to evaluate male fertility.

● Normal Range:

● Sperm Count: 15 million sperm per milliliter or more.

● Motility: At least 40% of sperm should be motile.

● Morphology: 4% of sperm should have a normal shape.

● Abnormal Range: Low sperm count (oligospermia), poor motility (asthenozoospermia), or abnormal sperm shape (teratozoospermia) can indicate male infertility.

● What It Signifies: Abnormal results may indicate male infertility, which can be due to hormonal imbalances, infections, lifestyle factors, or genetic conditions.

● Management: If sperm count is low, treatments may include sperm extraction, intrauterine insemination (IUI), or in vitro fertilization (IVF) with ICSI (intracytoplasmic sperm injection) for severe cases.

5. Anti-Müllerian Hormone (AMH) – Ovarian Reserve Assessment

AMH is a hormone produced by the ovaries, and its level is used to estimate the number of viable eggs remaining in the ovaries.

● Normal Range: 1.0–4.0 ng/mL.

● Abnormal Range: Lower levels may indicate diminished ovarian reserve or early menopause, while very high levels could suggest PCOS.

● What It Signifies: Low AMH levels indicate a reduced number of eggs available for fertilization, and may suggest premature ovarian insufficiency. High levels could suggest an ovulatory disorder like PCOS.

● Management: If AMH levels are low, egg freezing or egg donor programs may be considered. For high AMH, ovulation induction treatments may help regulate ovulation.