When women first start the process of fertility testing, all any of us really want to know is whether there is anything wrong, and whether we will be able to have a baby. Unfortunately, fertility tests don't always give the clear-cut answers we are looking for. Although they can pinpoint particular problems, the results are sometimes rather ambiguous, and you can go through a whole battery of tests and still emerge none the wiser as to why you aren't getting pregnant.
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The other main problem with fertility tests is that they seem to take so long. Testing is a matter of elimination, so doctors will start with the most straightforward test and work their way through the others until they find a clue as to what may be causing problems. There are often long gaps in between tests where you are waiting for results, and then waiting for the next appointment.
It can be very frustrating, especially if you are starting to worry about your age and feeling that your biological clock is ticking away, and your fertility is declining, while you wait. Paying for tests privately can sometimes speed up the process and reduce waiting time for appointments, but it can still take a while if the results prove inconclusive and you have to work your way through a number of different procedures.
'I expected that you would go straight to the doctor and they would tell you what was wrong with you. I didn't know a lot about infertility and how they go about diagnosing it I didn't realize how long it took to get to the bottom of what the problem was" Rachel, 35
Medical history
Your doctor will probably want to begin any assessment of your fertility by looking at your medical history. Your age, weight and menstrual cycle pattern may be relevant, and details of any previous surgery or sexually transmitted diseases can help form a picture of potential problem areas. Your doctor may also want to do an internal pelvic examination at this stage, and a cervical smear.
Your partner's medical history is important too, and your doctor needs to consider the two of you as a couple in order to work out where any problems could lie. Your partner should have a physical examination, as this can highlight any problems with the testicles or the tubes leading away from the testicles, which carry the sperm.
Blood tests
The first test you are likely to have is a blood test to check your hormone levels. These tests have to be carried out at the right point in your cycle. Doctors usually do a progesterone test to make sure you have ovulated, as progesterone is produced by the ovaries after an egg has been released and good progesterone levels indicate that you are ovulating normally. The progesterone test is done on day 21 of a regular 28-day cycle. If your cycle is shorter or longer, it is important to make sure that the timing is adjusted, as the results won't be accurate if the test is done at the wrong time. If you have irregular periods, it is going to be much harder to work out when you are ovulating, and you may have to have a series of blood tests to check your progesterone levels.
You should also have a test for the hormones that stimulate the ovaries to produce eggs. These are follicle stimulating hormone (FSH) and luteinising hormone (LH), and this test is normally done on day two or three of your cycle. High levels of FSH and LH indicate that your ovarian reserve (the number and quality of eggs remaining in the ovaries) is low, and this can make it harder for you to get pregnant.
If your periods are irregular, you may have a blood test to check your prolactin levels, as high levels of this hormone can affect your menstrual cycle. If doctors think thyroid disease is a possibility you may be tested for this too, as an underactive thyroid can affect egg quality an increase the risk of infertility and miscarriage.
Your doctor may also want to make sure that you are immune to rubella (German measles). Although German measles is not usually a serious illness, it can damage a baby during early pregnancy, and if you are not immune you will be told to avoid risking pregnancy until you have been immunized.
Sometimes your family doctor will be happy to carry out some of these basic blood tests before referring you to a specialist, whereas other doctors may prefer to refer you straight away. To find out more, you can check out Infertility Diagnostic Tests.
