Infertility: Essential Tests for Couples Trying to Conceive

excuse me?

The man is 32 years old and the woman is 26.
They have not used any contraception for one year and two months.
Last month, they started using ovulation test strips.
It has been 14 days since their last sexual intercourse, and her period is 3 days late.
She tested twice on March 7 and March 10, both results were negative.
They plan to get checked if her period comes this month.
Is this considered infertility? What tests should they undergo to understand their fertility status and capabilities? Thank you!

s, 20~29 year old female. Ask Date: 2016/03/10

Dr. Lin Wenbin reply Obstetrics and Gynecology

Two people go to the hospital for a clearer examination.

Reply Date: 2016/03/10

More Info

Infertility is a complex issue that affects many couples trying to conceive. In your case, you and your partner have been trying to conceive for over a year without success, which is a common timeframe that prompts couples to seek medical advice. The general medical definition of infertility is the inability to conceive after one year of unprotected intercourse for women under 35, and after six months for women over 35. Given that you are 26 and your partner is 32, you fall into the first category, and it is reasonable to consider this situation as infertility.

When it comes to understanding fertility and determining the underlying causes of infertility, both partners should undergo a series of tests. Here’s a breakdown of essential tests and evaluations that can help assess fertility:

For Women:
1. Hormonal Testing: Blood tests can evaluate hormone levels, including:
- Follicle-stimulating hormone (FSH): Important for ovarian function.

- Luteinizing hormone (LH): Plays a role in ovulation.

- Estradiol: A form of estrogen that indicates ovarian function.

- Progesterone: Helps assess ovulation.

- Thyroid hormones: Thyroid dysfunction can affect menstrual cycles and fertility.

- Prolactin: Elevated levels can interfere with ovulation.

2. Pelvic Ultrasound: This imaging test can check for abnormalities in the uterus and ovaries, such as cysts, fibroids, or polyps.

3. Hysterosalpingography (HSG): This X-ray procedure involves injecting dye into the uterus and fallopian tubes to check for blockages or abnormalities.

4. Ovulation Tracking: Keeping a record of menstrual cycles and using ovulation predictor kits can help determine if ovulation is occurring regularly.

5. Laparoscopy: In some cases, a minimally invasive surgical procedure may be necessary to look for conditions such as endometriosis or pelvic adhesions.

For Men:
1. Semen Analysis: This is one of the first tests for male fertility. It assesses sperm count, motility (movement), morphology (shape), and overall semen quality.

2. Hormonal Testing: Similar to women, men may also need tests for testosterone levels and other hormones that affect sperm production.

3. Genetic Testing: In some cases, genetic abnormalities can affect fertility, and testing may be recommended.

4. Physical Examination: A thorough physical exam can help identify any anatomical issues that could affect fertility.

Next Steps:
Since you mentioned that your menstrual cycle is irregular and you have been using ovulation predictor kits with negative results, it would be wise to consult a fertility specialist or an obstetrician-gynecologist (OB-GYN) who specializes in reproductive endocrinology. They can guide you through the necessary tests and help interpret the results.

Conclusion:
Infertility can be a challenging journey, but understanding the tests available and what they can reveal about both partners' fertility can provide clarity and direction. It’s essential to approach this process as a team, supporting each other emotionally and physically. Remember, many couples experience similar challenges, and with the right medical guidance, there are various options available to help achieve a successful pregnancy. Don't hesitate to seek help; early intervention can often lead to better outcomes.

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