News and pop culture have spotlighted infertility over the last few years. This is a positive development since it inspires discussion and removes some of the taboo, allowing those dealing with infertility to feel more comfortable opening up about their struggles. The media can get carried away, though, resulting in fear-mongering and public outcry.
Healthy women can become extremely worried about not being able to become pregnant even when they have only tried for a month or two. The truth is, infertility is not diagnosed until you have been trying for a year to get pregnant without success (if under age 35 – if you are older than 35, only six months of unsuccessful trying to conceive grants you an infertility diagnosis).
On a related note, your generally need to wait the full year for your health insurance to pick up the tab on your infertility consultation at a reproductive endocrinologist’s office.
How you can find out about your infertility right away
Let’s not waste time, shall we? If there is something to worry about, isn’t it better to know now?
There are a few blood tests you can get to get a sense of where your fertility is, and you may be able to ask your OB/GYN for these.
FSH test: Follicle stimulating hormone is a hormone involved in human reproduction and allows for growth and development within the ovaries. The ovaries produce eggs by way of follicles, and FSH is a driving force in that process, as well as in choosing the most mature follicle to devote the most energy toward ovulating the best egg.
What kind of numbers you can expect: A healthy FSH is around 6-8. If your level is high (over 12 – 15), it could indicate premature ovarian failure, and then it is time to see a fertility doctor immediately. If your FSH is low, you may be dealing with a different underlying condition that can affect your fertility.
AMH test: Antimullerian hormone is produced in growing follicles (under 8mm), and it can be judged on very specific scales and ranges based on age. AMH will change faster than FSH if your ovarian reserve is dropping (if you are coming close to menopause before your time). An AMH test can be run at any point during your cycle.
What kind of numbers you can expect: 1.5 to 4.0 is normal. As opposed to FSH, AMH levels above 4.0 indicate overactivity, such as PCOS, and levels under 1.5 may reveal diminished ovarian reserve.
What you need to know about hormone tests
You have to get your FSH tested on the third or fourth day of your period for the basal reading, meaning when the level is at its lowest, so that doctors will be able to get a sense of your ovarian reserve (how many eggs you have). Additionally, FSH can vary from month to month, so a single reading may not give you all the information you need.
Be sure to call ahead to request these tests, because at least one has to be conducted at a certain day of your menstrual cycle.
Infertility is a couple’s issue (not just a woman’s)
Infertility has historically been viewed as a woman’s problem, but it’s actually a couple’s issue. Even if your blood tests come back normal, your man’s sperm may not be up to the task of fertilization. He can get a referral by a general practitioner or a urologist for a semen analysis (if his health insurance requires a referral). He will provide a sperm sample to a reproductive endocrinologist or a hospital which will be evaluated in an andrology lab for the sperm’s quantity, morphology (shape) and motility (ability to move). At times, a second test is requested a few weeks later to make sure the results are consistent.
What have we learned?
Sometimes, it takes a little while to get pregnant. That’s just how nature works. And if you are in your late 30s, expect to try to conceive for a few months and then seek out an infertility specialist. If you are under 35 years old and you and your partner have a clean bill of health, keep trying to get pregnant! If you still don’t have luck after a year, make an appointment to see a fertility doctor. Unexplained infertility is not uncommon, but it’s a game-changer, and you may need a doctor’s intervention to be able to achieve your dream of becoming a parent – or in some cases, becoming a parent again.
To learn more about reproductive hormone testing, click these links:
Filed under: Infertility Treatment