Fertility Testing For Women
When planning to start a family, fertility testing may be an important consideration for many women, especially if conception is unsuccessful after several months of trying. Diagnosing fertility status requires a very comprehensive first appointment in which many topics are discussed, such as birth control use, partner’s fertility status, menstrual history, sexual practices, surgical history, medications, lifestyle, diet, work and home environment, stress levels, and so much more. Along with that, a well women’s exam may be performed to check the thyroid, breasts, hair growth, and pelvic organs. A pap smear may also be done if one has not been performed recently.
Ovulation
Your physician will also talk to you about your menstrual cycle and ovulation tracking. Knowing at what point in your cycle you are ovulating is important because that is the time that you are most likely to conceive. Taking your temperature every morning right after you wake up is one way of tracking ovulation. On the day you are ovulating, your basal body temperature is likely to increase due to the increase in progesterone as your hormones are changing during your cycle. Another way to track this is by taking ovulation predicting kits, which are similar to pregnancy tests, except they test for an LH surge, which occurs right before an egg is released. This tells you when the best time to have sex is in order to increase your chances of getting pregnant.
Cervical Mucus
Cervical mucus is an important component in the conception process because it provides nourishment and protection for the sperm as it makes its way from the vagina to the fallopian tube. Cervical mucus production is stimulated by estrogen and secreted by the cervix. The quality and quantity of cervical mucus fluctuates throughout the menstrual cycle, just like hormones and basal body temperature do. As you approach ovulation, estrogen and LH levels surge in the body, which causes the cervix to secrete more mucus than usual. A healthy cervical mucus during this time should be clear, stretchy, and an egg white consistency. This is the perfect medium for sperm to travel in terms of texture and pH. The best way to know about your cervical mucus is to check it on a daily basis. You may notice some on your underwear from time to time and sometimes it may be on toilet paper as you’re wiping. You may also insert your middle and index fingers into your vagina, going up to your cervix as far as you can. Then remove your fingers and observe the consistency of the mucus.
Hormones
If you and your physician are concerned about anovulation or other diseases that may be negatively impacting your fertility, hormone testing is the best way to approach this problem. Some common hormones that are tested are:
Anti-Mullerian Hormone: AMH is an indicator of your ‘ovarian reserve,’ or how many eggs you have left. The more eggs you have, the higher the AMH will be.
Follicle-Stimulating Hormone: FSH is one of the hormones essential to pubertal development and the function of women’s ovaries. It can help diagnose and evaluate a number of reproductive health matters including menopause, PCOS, ovarian cysts, abnormal vaginal or menstrual bleeding, and fertility problems.
Estradiol: This test indicates how well the ovaries are working. Estradiol causes maturation and release of the egg, as well as thickening of the uterus lining to allow for implantation of the fertilized egg. Levels naturally decline as women age.
Luteinizing Hormone: LH is the hormone whose levels increase at the time of ovulation. Both high and low levels of LH can cause infertility. High levels are often connected to PCOS and increased production of testosterone. Low levels of LH ultimately cause ovulation to stop occurring.
Prolactin: Prolactin is tested when there are irregular period or fertility problems. It helps to rule out conditions that could be caused by the pituitary or hypothalamus.
Thyroid Stimulating Hormone: TSH is tested to determine underlying diseases such as hypo- or hyperthyroidism, which could both affect ovulation and fertility.
Fasting Glucose: a glucose level that is within normal limits is important for women who are trying to become pregnant. A level that is too high indicates impaired glucose tolerance/insulin resistance, which increases the risk of miscarriage and birth defects.
Remember that fertility treatment is a lot more than just hormone testing, supplementation, and stress reduction. Each patient should have an individual health protocol that should be discussed with their healthcare provider or fertility specialist. If you are having trouble conceiving, consider talking to someone in order to get labs tested and a healthy fertility plan started for you and your partner.