When a couple comes to a fertility clinic after a period of time searching for pregnancy without success, a fertility study is performed on both the man and the woman. These tests are used to try to find out the causes of infertility in the couple, but also to guide the specialist in the most appropriate assisted reproduction treatment.
For this reason, fertility tests are also performed for women who wish to become single mothers and for couples of women. In this way, the specialist will be able to evaluate the most appropriate treatment to help them achieve motherhood.
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When to do fertility tests?
In general, the recommendation is that the couple should visit a fertility center after 12 months of frequent sexual intercourse without contraceptive protection if pregnancy has not been achieved during this period.
However, if the woman is over 35 years of age, it is recommended that the couple see a specialist after 6 months of pregnancy. The reason is that age is especially detrimental to female fertility, as the number and quality of eggs decreases.
In this way, the couple can undergo a fertility study and, depending on the results, the most appropriate treatment to help them achieve pregnancy will be evaluated.
On the other hand, it is important to mention that women who decide to face motherhood alone and female couples should also undergo a fertility study before undergoing assisted reproduction treatment. Thus, the specialist will be able to indicate which treatment is the most appropriate.
Assisted procreation, as any other medical treatment, requires that you rely on the professionalism of the doctors and staff of the clinic you choose. Obviously, each clinic is different. Get now your Fertility Report, which will select several clinics for you out of the pool of clinics that meet our strict quality criteria. Moreover, it will offer you a comparison between the fees and conditions each clinic offers in order for you to make a well informed choice.
What does the fertility study consist of?
Initially, a medical history will be taken, which the specialist will begin to complete with questions aimed at finding out the general state of health of the patients, their background (personal and family), as well as their habits.
Similarly, he will also be interested in questions such as the couple's infertility time. In addition, the specialist will also order a series of tests and analyses. However, this fertility study is different for women and men.
Female fertility tests.
In addition to a complete gynecological examination and cytology, the main fertility tests that the specialist may request from the woman are:
- Hormonal blood test, which will determine the concentration of hormones such as antimüllerian hormone (AMH), follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone and prolactin. This analysis is performed in the first days of the menstrual cycle, except for the determination of progesterone, which is performed around day 21 of the cycle. In addition, a general blood test and serology for certain infectious diseases (hepatitis B and C, HIV, syphilis, etc.) will also be performed
- Transvaginal ultrasound, to evaluate the status of ovaries, tubes and uterus and to perform an antral follicle count (AFR). The RFA allows estimating the woman's ovarian reserve, together with the determination of the AMH hormone.
- Karyotyping, to see if there are alterations in the number or structure of the chromosomes that may cause fertility problems. It is performed on the basis of a blood test.
- Hysterosalpingography or hysterosonosalpingography, which allow the patency of the fallopian tubes to be checked by X-ray or ultrasound, respectively.
- Hysteroscopy, which allows direct observation of any alterations in the uterus, such as fibroids.
- Endometrial biopsy, from which various tests can be performed to study the endometrial factor (such as the endometrial receptivity test or tests to study the microorganisms present in the uterus).
However, a woman's fertility study generally does not require all of these tests. The study is usually completed with the tests indicated by the specialist according to the clinical history and the results of the previous tests.
You can read more detailed information about female fertility testing here: What are female fertility tests and what do they consist of?
Male fertility tests
In the case of the male, in addition to a physical examination (which may include an ultrasound of the genital tract, to rule out possible abnormalities), the tests that can be performed in the fertility study are:
- Seminogram, i.e., a basic semen analysis in which aspects such as sperm concentration, motility and morphology are evaluated. This test can be completed with a motile sperm count(MSC) after processing (capacitation) of the semen sample in the laboratory for more information. It is performed from a seminal sample collected in a sterile container and obtained by masturbation.
- Hormonal blood analysis, where the determination of testosterone, among other hormones, becomes relevant. In addition, the male will also undergo a general analysis and serology.
- Karyotyping, which will allow us to observe if there is any anomaly in the number and structure of the chromosomes causing infertility. As in the case of women, it only requires a blood test.
- DNA fragmentation study of spermatozoa, to assess the integrity of their DNA from a semen sample.
- FISH of spermatozoa, to evaluate whether spermatozoa have normal chromosomal content. A seminal sample is also required for its performance.
- Y chromosome microdeletionsthis will make it possible to study whether these deletions exist, especially in males with severe oligospermia or azoospermia. It is determined from a blood test.
- Semen culture, to detect the presence of microorganisms in semen.
- Testicular biopsy, which consists of a surgical procedure to check for sperm production in males with azoospermia.
As in the female case, all these tests are not always necessary. The fertility study of the male is complemented according to the clinical history and the results obtained in the previous tests.
If you want to know more about male fertility testing, you can read this article: Fertility tests in men: what are they and what do they consist of?
FAQs from users
In a female couple, should both women undergo fertility testing?
Not in all cases will both members of the couple have to undergo the complementary tests that are part of the fertility study. This will be conditioned by the different techniques that can be used in these cases:
- Artificial insemination with donor sperm (AID), in vitro fertilization with own gametes/ovodonation with donor sperm (same assumption as single woman), embryo donation: fertility study will only be necessary in the woman who performs the treatment.
- ROPA Method: a donor (the one who performs the ovarian stimulation and oocyte retrieval) and a recipient (the one who performs the embryo transfer) will be defined. Both roles will entail a series of specific complementary tests that will be explained in consultation.
Are there any home female fertility tests?
No, fertility tests can only be done in a gynecological center. The only test that a woman can do at home is a study of the time of ovulation, which can be done in a simple way with a pharmacy ovulation test. It is important to keep in mind that this test measures the LH peak that is produced to induce ovulation, but without going to a doctor it is not possible to know if ovulation really occurs or if it is adequate.
What is the cost of fertility tests for males?
The cost of male fertility tests can range from $50-300, although it depends on the clinic chosen. As for blood tests, the price can range from $200-400. In case you require additional tests, an increase of the overall cost should be expected.
How much does a fertility study cost?
In general, a basic female fertility study has an approximate price of between €150 and €400, although this depends on the tests required and the center where they are carried out.
Specifically, a hysterosalpingography has an approximate cost of between €100 and €150. Transvaginal ultrasound, cytology and a gynecological examination can cost 50-150 €, and hormone analysis another 100-150 €.
Suggested for you
If you are interested in learning more about the causes of sterility and infertility, we recommend you visit this link: What are the main causes of sterility and infertility?
On the other hand, if you would like to learn more about fertility treatments, you can read the following article: Fertility treatments for couples: how to achieve pregnancy?
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References
Assidi M. Infertility in Men: Advances towards a Comprehensive and Integrative Strategy for Precision Theranostics. Cells. 2022 May 22;11(10):1711. (View)
Cedars MI. Evaluation of Female Fertility-AMH and Ovarian Reserve Testing. J Clin Endocrinol Metab. 2022 May 17;107(6):1510-1519. (View)
Concepción-Zavaleta M, Paz Ibarra JL, Ramos-Yataco A, Coronado-Arroyo J, Concepción-Urteaga L, Roseboom PJ, Williams CA. Assessment of hormonal status in male infertility. An update. Diabetes Metab Syndr. 2022 Mar;16(3):102447. (View)
Devine K, Dolitsky S, Ludwin I, Ludwin A. Modern assessment of the uterine cavity and fallopian tubes in the era of high-efficacy assisted reproductive technology. Fertil Steril. 2022 Jul;118(1):19-28. (View)
Esteves SC, Zini A, Coward RM, Evenson DP, Gosálvez J, Lewis SEM, Sharma R, Humaidan P. Sperm DNA fragmentation testing: Summary evidence and clinical practice recommendations. Andrologia. 2021 Mar;53(2):e13874. (View)
Farkouh A, Finelli R, Agarwal A. Beyond conventional sperm parameters: the role of sperm DNA fragmentation in male infertility. Minerva Endocrinol (Torino). 2022 Mar;47(1):23-37. (View)
Khodavirdilou R, Pournaghi M, Rastgar Rezaei Y, Hajizadeh K, Khodavirdilou L, Javid F, Hamdi K, Shahnazi M, Nouri M, Fattahi A, Beckmann MW, Dittrich R. Does Anti-Müllerian hormone vary during a menstrual cycle? A systematic review and meta-analysis. J Ovarian Res. 2022 Jul 1;15(1):78. (View)
WHO laboratory manual for the examination and processing of human semen, sixth edition. Geneva: World Health Organization; 2021. (View)
FAQs from users: 'In a female couple, should both women undergo fertility testing?', 'Are there any home female fertility tests?', 'What is the cost of fertility tests for males?' and 'How much does a fertility study cost?'.
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