Fertility tests are performed to study the factors that might be delaying a pregnancy. They can also be done to know the fertility status before oocyte or sperm preservation. Whenever you are thinking about finding out how fertile you are, the first thing you must know is the normal fertility status at your age. We show you, in this graphic, the monthly probability of pregnancy depending on age.
The monthly probability of pregnancy goes from 20-25% when we are bellow 30, to around 15% up till 38, and down bellow 10% above that age. Taking this into account, it is recommended to do a fertility study if you are younger than 35 and have not become pregnant after a year of trying; or if you are 35 or older and after 6 months you have not achieved a pregnancy. The reason is that, after that time, the chances of pregnancy will go down to very low levels, and any reproduction treatment will improve those chances significantly. We show you here the most frequent tests. At the first consultation we will evaluate which are the ones appropiate for you.
Measuring certain hormones in a blood test will give us information on the ovarian reserve and function. We can measure FSH, LH and estradiol between day 3 and 5 of the menstrual cycle, which, additionally, will give us a prognosis on how well ovaries might respond to an ovarian stimulation; or we can measure the levels of Antimullerian Hormone (AMH), at any time of the menstrual cycle.
A transvaginal scan will give us information on the ovaries, uterus and Fallopian tubes. In the ovaries, the antral follicle count will reflect the ovarian reserve. Additionally, we could observe cysts from endometriotic or other origins. In the uterus we will be able to diagnose the presence of polyps, fibroids or other anatomic pathologies that could limit the female fertility.
Additional tests include the annual gynaecological examination, vaginal and endocervical cultures and an evaluation of the uterus and Fallopian tubes with hysterosalpingogram, hysteroscopy, hysterosonography or laparoscopy. In the male, it could include a urethral culture, DNA sperm fragmentation, sperm FISH analysis, and recesive genetic diseases test that can confirm the “genetic compatibility” with a donor in case of egg donation.
A consultation with the nutritionist is needed in case of malnutrition by default or excess (obesity). A body mass index (BMI) outside the normal limits is associated, in both men and women, with a diminished fertility and a higher risk of miscarriage and other gestational pathologies.