Test for Infertility

What is Infertility?

Infertility is a condition affecting the reproductive system, preventing individuals from conceiving. It may arise from various causes. 

The process of conception involves several sequential steps:

1. Hormones from the brain regulate ovarian function.
2. An egg matures within the ovary.
3. Ovulation occurs as the ovary releases the egg.
4. The fallopian tube picks up the egg.
5. Sperm travels through the vagina, uterus, and reaches the fallopian tube.
6. Fertilization happens when sperm meets egg, forming an embryo.
7. The embryo travels through the fallopian tube to implant in the uterus.

A pregnancy can’t occur if anything in this process doesn’t happen.

What are the types of Infertility?

Type of infertility includes:

1. Primary infertility: Occurs when individuals have never achieved pregnancy despite regular, unprotected intercourse for one year (or six months if aged 35 or older).
2. Secondary infertility: Refers to the inability to conceive again after previously achieving at least one successful pregnancy.
3. Unexplained infertility: Describes cases where fertility testing fails to identify a specific reason for the inability to conceive.

What are the Symptoms of infertility?

The primary indicator of infertility is the inability to conceive after six months to one year of consistent, unprotected sexual activity. While some individuals may not exhibit additional symptoms, others might experience physical signs such as:

1. Pelvic or abdominal discomfort.
2. Irregular vaginal bleeding, unpredictable menstrual cycles, or absence of menstruation.
3. Male-specific issues like penile disorders or difficulties with ejaculation.

What Causes Infertility?

Various factors may contribute to infertility, impacting either one partner or both. Common risk factors include:

1. Advanced age, particularly being in one's late 30s or 40s. For men, fertility may be affected closer to age 50.
2. Eating disorders such as anorexia nervosa and bulimia
3. Excessive alcohol consumption
4. Exposure to environmental toxins like chemicals, lead, and pesticides
5. Over-exercising
6. Undergoing radiation therapy or chemotherapy
7. Contracting sexually transmitted infections (STIs)
8. Smoking and tobacco use, influencing around 13% to 15% of infertility cases
9. Substance abuse
10. Obesity or being underweight
11. Hormonal abnormalities affecting the brain's hormone-producing centers (hypothalamus or pituitary)
12. Chronic health conditions

How is Infertility Diagnosed?

There are several blood tests that can be done to diagnose infertility in either you, your partner, or both. Your infertility specialist will recommend blood tests for infertility based on history. 

A few infertility blood test are:

• FSH Testing

Follicle-stimulating hormone (FSH) plays an important role in regulating a woman's menstrual cycle and stimulating the growth of follicles in the ovaries, which contain eggs. 

A blood test to measure FSH levels is typically conducted on the second or third day of the menstrual cycle to assess egg supply and ovarian function.

In men, FSH is essential for the production and transportation of sperm, and the test is used to evaluate sperm count.

• Estradiol

Estradiol is an important form of estrogen. An estradiol test measures ovarian function and evaluates egg quality. Similar to FSH, it is performed on the second or third day of the menstrual cycle.

• Luteinizing Hormone (LH) Level

In women, luteinizing hormone (LH) is linked to ovarian hormone production and egg maturation. A luteinizing hormone test performed at the beginning of menstruation cycle may help diagnosing hormonal imbalances, like PCOS. 

When LH testing is performed midway through menstrual cycle (day 14 of a 28-day cycle), the level may assist in determining when a female is ovulating.

In men, LH stimulates the production of testosterone, which impacts sperm production. An LH test can be useful in assessing male-factor infertility.

• Anti-Müllerian Hormone (AMH)

AMH is secreted by the small antral follicles in the ovary and is present until a woman reaches menopause. Testing AMH gives a physician a good understanding of ovarian function and egg reserve. Lower AMH levels may indicate a reduced egg yield, leading to a lower likelihood of success for patients undergoing IVF.

AMH test may be done at any point during menstrual cycle, and may also be done if the person is  taking oral contraception.

• Serum Progesterone

Progesterone, a female hormone produced by the ovaries during ovulation, prepares the uterine lining to receive a fertilized egg. A serum progesterone test is used to confirm if ovulation is occurring.

Because progesterone levels rise towards the end of a woman's cycle, this test is conducted during the luteal phase, just before menstruation begins.

• Prolactin

Prolactin is a hormone produced by the pituitary gland, which stimulates milk production.

In women, a prolactin test may be conducted to evaluate infertility, determine the cause of anovulation, or investigate symptoms such as nipple discharge.

In men, a prolactin test is used to assess issues like low sexual desire, erectile dysfunction, or potential pituitary gland problems.

• Androgen

Testosterone is an androgen which impacts the sexual functioning of both men and women.

In women, an androgen test is used to evaluate conditions such as polycystic ovarian syndrome (PCOS).

In men, an androgen test helps identify the causes of low sex drive, erectile dysfunction, or infertility.

How Can One Prevent Infertility?

To safeguard your fertility, particularly when planning to conceive, consider these steps:

1. Maintain a balanced diet and achieve a healthy weight.
2. Avoid smoking, drug misuse, and excessive alcohol consumption.
3. Seek treatment for sexually transmitted infections (STIs).
4. Minimize exposure to environmental toxins.
5. Stay physically active without overexertion.
6. Consider the timing of conception to avoid advanced age.
7. Explore fertility preservation options such as egg or sperm freezing procedures.

These measures may help promote optimal fertility health and increase the chances of successful conception when desired.