Family planning and fertility testing options - Ruth Health

Family planning and fertility testing options

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Fast facts:

  • Multiple tests may be used to identify potential causes of infertility and help your doctor recommend the best treatment options.
  • An evaluation for female infertility may consist of a urine test, blood tests that check for fertility-related hormones, and imaging tests.
  • An evaluation for male infertility typically begins with a semen analysis to evaluate sperm quantity, quality, and motility.
  • If you are 35 or older, it is recommended to seek an evaluation for infertility after six months of trying to conceive.
  • If you are younger than 35, it is recommended to seek an evaluation for infertility after a year of trying to conceive.

There’s no one-size-fits-all fertility treatment. The best approach depends on the underlying cause of your or your partner’s infertility and various factors related to your reproductive health.

A reproductive specialist may use multiple tests to evaluate your fertility and make recommendations for treatment, including ovulation tests, ovarian reserve testing, and evaluations for uterine or cervical abnormalities.

Some of these tests can also help your doctor modify your medication protocol in an IVF cycle.

Here’s more on family planning and fertility testing options.

What are the leading causes of infertility?

Fertility tests check for many different causes of male and female infertility.

Female infertility often stems from a complication with the ovaries, fallopian tubes, or uterus.

Common female infertility issues include:

  • Disruption of ovarian function and ovulation issues
  • Uterine or cervical abnormalities
  • Fallopian tube obstruction

Most cases of male infertility relate to issues with sperm production or motility.

Take a closer look at the causes of male and female infertility.

Family planning and fertility tests for women

Just as there’s no one-size-fits-all fertility treatment, there isn’t one single test that answers every question about your fertility.

Multiple infertility tests may be used in an evaluation for female infertility, including a urine test, blood tests, and imaging tests. Each one serves a distinct purpose, offering a snapshot into certain aspects of your reproductive health. 

Here’s what you can expect to learn from different fertility tests for women.

Urine test

A urine test can help you understand when and if you’re ovulating by measuring the levels of luteinizing hormone (LH) in your urine.

A surge in LH triggers ovulation. If a urine test detects an increase in this hormone, it typically indicates the likelihood of ovulation within the next 24 to 48 hours. This allows you to try to conceive during your most fertile days.

Progesterone test

Progesterone is a hormone produced during ovulation that prepares the uterus for implantation of a fertilized egg.

A progesterone test is a simple blood test that measures your levels of progesterone to determine if you are ovulating and identify potential issues with ovulation. 

To ensure accurate results, it should be conducted during the luteal phase of your menstrual cycle, right before the start of your period, when progesterone levels increase.

Prolactin test

Prolactin is a hormone related to breast milk production that can interfere with ovulation. (While breastfeeding in general should not be considered birth control, individuals who are breastfeeding every three to four hours typically produce enough prolactin to inhibit ovulation.) Higher levels of prolactin may be associated with an ovulation disorder.

A prolactin test is a simple blood test that measures your levels of prolactin. To ensure accurate results, it should be conducted in the morning after an overnight fast and early in your menstrual cycle, as prolactin levels increase after ovulation.

Follicle stimulating hormone 

Follicle stimulating hormone (FSH) helps regulate your menstrual cycle and stimulates ovulation. Higher levels of FSH may indicate a lower ovarian reserve.

An FSH test is a simple blood test used to evaluate your ovarian reserve. To ensure accurate results, it should be conducted on the second or third day of your menstrual cycle.

Anti-mullerian hormone

Anti-mullerian hormone (AMH) is associated with your ovarian reserve. Lower AMH levels may indicate a lower ovarian reserve. 

In some cases, lower AMH may be associated with lower egg yield in an IVF cycle, however that isn’t always the case, and AMH levels cannot reveal egg quality.

An AMH test consists of a simple blood draw for ovarian reserve testing. It may be conducted at any time since AMH levels remain consistent throughout a menstrual cycle.

Estradiol test

Estradiol, a form of estrogen, is a hormone associated with your ovarian reserve. Higher levels of estradiol may indicate a lower ovarian reserve or an issue with FSH, as estradiol can suppress FSH. In some cases, elevated estradiol may also be associated with lower IVF success rates.

An estradiol test consists of a simple blood draw for ovarian reserve testing. To ensure accurate results, it should be conducted on the second or third day of your menstrual cycle.

Ultrasound

During an infertility evaluation, an ultrasound may be used to identify potential issues with your ovaries, endometrial lining, and uterus. This allows your doctor to evaluate your ovarian reserve and identify uterine abnormalities or fallopian tube obstruction.

These scans use high-frequency sound waves to create an image of your reproductive organs. Both abdominal and transvaginal ultrasounds may be used.

Sonohysterography

A sonohysterography is a specific type of ultrasound that offers a more detailed look at the inside of your uterus.

Hysterosalpingogram

A hysterosalpingogram (HSG) uses a special type of x-ray to offer a more detailed look at the fallopian tubes and the inside of your uterus.

Hysteroscopy

A hysteroscopy inserts a small camera with a thin light source through the cervix and into the uterus to identify uterine abnormalities.

Laparoscopy

A laparoscopy inserts a small camera with a thin light source through the abdomen to identify fallopian tube obstruction, uterine abnormalities, or issues with ovarian function.

Basal body temperature tracking at home

Your basal body temperature (BBT) typically rises during ovulation. Taking your temperature by mouth every morning for two or three menstrual cycles can help you track ovulation.

Family planning and fertility testing for men

An evaluation for male infertility typically begins with a semen analysis. This helps identify sperm quantity, quality, and motility.

You will provide your doctor with a sample of your semen. The sample is typically taken by masturbating but you can also collect it by having sex with a condom or withdrawing before ejaculating.

If your semen sample indicates potential issues with sperm production, a common next step is blood work to measure your levels of testosterone, follicle stimulating hormone, and, less commonly, serum LH and prolactin.

Sometimes additional infertility tests are necessary to identify a more precise cause of male infertility and confirm a diagnosis.

Ultrasounds can detect abnormalities of the testicles, prostate, or the tubes that transport semen. Blood tests can help identify genetic causes of a low sperm count.

When should I consider fertility testing?

It is recommended to consult a reproductive specialist for potential infertility tests if you are:

  • 35 or older and have not become pregnant after six months of regular, unprotected sex
  • Younger than 35 and have not become pregnant after a year of regular, unprotected sex
  • Older than 40 and intend to conceive

You may also consider a fertility evaluation if you have experienced at least two successive pregnancy losses or have a health condition linked to infertility.

If you have additional questions regarding infertility, consult your physician or a trusted healthcare professional to discuss diagnosis and treatment options.

Ruth Health is here to provide you with expert, evidence-based maternal care and advice.

If you’re interested in learning more about a particular topic, send us an email at hello@ruthhealth.com. Join our community by signing up below.

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