Testing for infertility depends on your reproductive history including menstrual cycle intervals, age, weight and other factors. Testing may be different for women with regular menstrual cycles occurring every 25-35 days than for women whose cycles are outside of these parameters. Testing may also be different for women who are either under or over weight and for women who may have become pregnant but who have not had a successful delivery.
Testing can often be minimal in women of ideal body weight with regular cycles who are unable to conceive after trying for a year if they are under age 35 or trying for six months if they are 35 years of age or older. Testing in the man should always include a semen analysis and blood for an infectious disease screen (HIV I & II, Hepatitis B & C and RPR). Testing in the woman should include blood tests ideally obtained between Cycle Day 2-4 measuring the following:
1) Follicle Stimulating Hormone (FSH);
2) Estradiol (E2);
3) Anti-Mullerian Hormone (AMH)-can be measured anytime during the cycle
4) Thyroid Stimulating Hormone (TSH);
5) Prolactin (PRL)
6) Hemoglobin (Hgb)
7) Blood Type and Rh;
8) Rubella Immunity;
9) Varicella Immunity;
10) Infectious Disease Screen (HIV I & II, Hepatitis B & C, RPR);
A pelvic ultrasound and an intrauterine structural study should also be obtained such as a Sono-hysterogram (SonoHSG) or a Hysterosalpingogram (HSG).
Another test that should be considered by anyone contemplating pregnancy is a genetics screen looking for specific mutations such as cystic fibrosis (CF), Spinal Muscular Atrophy (SMA) and other mutations included in commercial tests provided by Good Start Genetics and other companies.
Following these minimal, cost-effective tests a plan can be formulated to help you achieve a successful pregnancy. Contact us today for consultation and for those without insurance, it is free!