We have a very comprehensive fertility testing protocol to use with patients and couples participating in the Natural Fertility Breakthrough program.
There are at least 50 parameters or tests that may need to be performed for a couple experiencing fertility problems in order to rule out possible reasons or cause for infertility. However, if I could only request 4 tests for a couple I would absolutely make sure to order the following:
Thyroid function test + Thyroid antibodies (Female) When: Any time in the cycle
Proper thyroid function is vital for ensuring the mother’s and the developing embryo’s metabolism both work effectively. The risk of miscarriage and developmental complications in the fetus are likely to be increased by strain on the hypothalamus-pituitary- thyroid axis (often present in cases of female infertility). Similarly, permanent thyroid damage can occur as a result of thyroid antibodies, if this is happening it’s important to find out and use other methods necessary to ensure the thyroid does not become the reason for infertility and even recurrent spontaneous abortions.
Vaginal Swab and Culture (Female) When: Any time in the cycle
These are important infections to be ruled out, which can negatively impact a couple’s ability to conceive and a woman’s ability to keep a healthy pregnancy to term because they can affect a pregnancy in its very early stages. In addition many of the sexually transmitted infections pose a very real concern to a developing pregnancy and embryo. It’s recommended a woman has a high vaginal swab performed by her GP or specialist that includes a general culture and also specifically excludes ureaplasma and mycoplasma.
FSH (Female) When: Day 2 of Cycle
All the relevant hormonal tests must be done to ensure the appropriate balance can be ascertained for optimum results. Without the suitable amount of estrogen eggs do not mature effectively; high FSH levels suggest possible ovarian failure or compromised ovarian function; LH:FSH ratio imbalances can lead to a diagnosis of PCOS even when the menstrual cycle is regular and therefore must be checked; For a similar reason DHEA, Testosterone, FAI, SHBG must all be tested.
Prolactin is used to ascertain pituitary function and therefore proper signalling and overall hormonal balance. AMH is a useful test to help ascertain ovarian research (i.e. the quantity of eggs left—however it gives no clue as to egg quality). Finally progesterone should be tested here also in order to ascertain its baseline.
However if only one test could be ordered FSH would be the obvious test because if a woman’s FSH levels are too high a pregnancy is unlikely to occur without treatment
Semen analysis, IBT, SCSA, Culture (Male) When: Anytime ASAP
It’s vital to ensure a semen analysis is performed at a specialist fertility/IVF lab; In addition, I would request an immunobead test to rule out anti-sperm antibodies and a SCSA or DNA fragmentation test as well as a semen culture to rule out possible infections. This is the best way to ensure male fertility is optimum in order that any couple can achieve peak fertility.
Your fertility testing results are one of the first things we address when working with couples. Join the Fertility Challenge and we’ll help you understand your fertility testing results.