Should You Get Fertility Testing After Miscarriage? Expert Advice - Obstetrics and Gynecology

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After experiencing a miscarriage, many women find themselves grappling with the emotional and physical aftermath, including concerns about future fertility. In your case, having had a miscarriage at 15 weeks and then not conceiving after several months of unprotected intercourse raises valid questions about whether to pursue fertility testing.

Firstly, it is important to understand that miscarriages are relatively common, with estimates suggesting that 10-20% of known pregnancies end in miscarriage. Factors contributing to miscarriage can include chromosomal abnormalities, maternal health issues, and anatomical problems. After a miscarriage, it is not unusual for menstrual cycles to take some time to regulate, which can lead to uncertainty regarding ovulation and fertility.

Given that you have been tracking your basal body temperature and have noticed a pattern in your cycles, this is a positive step toward understanding your ovulation patterns. However, if you have been trying to conceive for several months without success, it may be prudent to seek fertility testing. The general recommendation is to consider fertility evaluation if you have been trying to conceive for one year if you are under 35, or for six months if you are 35 or older. Since you have already experienced a miscarriage, it may be reasonable to consult with a fertility specialist sooner.

When you visit a fertility clinic, the evaluation typically includes a comprehensive medical history, physical examination, and various tests. These may include:
1. Hormonal Testing: Blood tests to check hormone levels, including thyroid hormones, prolactin, and reproductive hormones (FSH, LH, estradiol, and progesterone).


2. Ovulation Assessment: This can be done through tracking ovulation via basal body temperature, ovulation predictor kits, or blood tests to measure progesterone levels during the luteal phase.

3. Ultrasound: A pelvic ultrasound can help assess the health of your ovaries and uterus, checking for conditions like polycystic ovary syndrome (PCOS) or uterine abnormalities.

4. Hysterosalpingography (HSG): This X-ray procedure checks for blockages in the fallopian tubes and assesses the shape of the uterine cavity.

5. Semen Analysis: If applicable, a semen analysis for your partner can help rule out male factor infertility.

Regarding the timing of your visit, it is generally advisable to schedule your appointment during the first half of your menstrual cycle, ideally between days 3-5, when hormone levels can be accurately assessed. However, if you have irregular cycles, your healthcare provider may guide you on the best timing based on your specific situation.

In conclusion, given your history of miscarriage and the challenges you are facing in conceiving again, seeking a fertility evaluation is a reasonable next step. This process can provide you with valuable insights into your reproductive health and help identify any underlying issues that may be affecting your ability to conceive. Remember, you are not alone in this journey, and there are resources and support available to help you navigate your path to parenthood.