How do you test for infertility?
If someone with a uterus, ovaries, and vagina has been charting their cycle and having semen producing sex or inserting semen into their vagina during their ovulatory cycle for at least a year and has not gotten pregnant, then we can start looking for what might be causing the disconnect.
There are 3 main sources of infertility issues:
Structural issues with the uterus/vagina
Hormonal issues in the person attempting to conceive
Problems with the quality or quantity of semen
Structural issues might be:
Fibroids are masses of non-cancerous muscle that grow in/on/around the uterus and can make it hard for a fertilized egg to implant in the wall of the uterus.
Blocked ovarian tubes could be caused by a number of things, such as a previous infection that caused scarring in the tubes, a sterilization procedure, or damage from an ectopic pregnancy (pregnancy in the tubes).
Abnormal uterus. There are plenty of ways in which the structure of the uterus itself can be a problem, such as a uterus with a band of tissue down the middle, a uterus with scarring or excess connective tissue spanning the middle of the cavity.
Endometriosis is a condition in which uterine tissue grows outside the uterus.
To assess for these issues, usually the provider will order a transvaginal or abdominal ultrasound.
Hormonal issues might be:
Luteal phase defect happens when one section of the menstrual cycle is too short, making it so that the uterine lining can’t build up enough to make a nice lush pillow for the fertilized egg.
Diminished ovarian reserve is generally the name for what happens later in life when you don’t have as many eggs as you did as a teenager. Fewer eggs = fewer chances to get pregnant.
Polycystic Ovarian Syndrome (PCOS) is a syndrome in which the hormone levels are off, making it so that you do not have regular periods and therefore are often not ovulating at all.
Premature Ovarian Failure is when someone under the age of 40 has no more eggs to use.
All of these can be tested for by blood tests at certain times during the cycle.
Problems getting the sperm out (similar to structural issues listed above, but for the semen-making partner).
Abnormally shaped sperm, which can be caused by a genetic trait, exposure to toxic chemicals, or increased testicular temperature.
Too few sperm, not enough semen
History of prostate surgery, spinal cord injury, certain medications, pituitary tumors, congenital lack of LH/FSH (pituitary problem from birth), steroid abuse, infections or injury
These can be tested for by testing a semen sample and in some cases blood tests.
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