Fertility Testing
and Diagnosis

Discovering the root cause of your infertility

If you’re experiencing infertility, you’re not alone. Fertility struggles affect both men and women and are quite common. With the help of a knowledgeable fertility doctor, you can address the root cause with the most effective treatments. 

Fertility testing is essential to choose the best treatment options. Your doctor will perform an initial examination and assessment before selecting the most appropriate fertility tests. Here are some common fertility tests your doctor may request:

Ovarian Reserve

Testing ovarian reserve is essential for discovering your baseline numbers in relation to where your doctor wants them to be. Your ovarian reserve refers to the reproductive potential of your ovaries in the number and quality of eggs that you have. Testing ovarian reserve begins with an ultrasound and bloodwork to test your hormone levels. This usually happens around day three of your period to more accurately see how your hormones are behaving. Bloodwork also includes testing how much anti-müllerian hormone (AMH) is in your blood. This gives us a good picture of where you’re starting from. 

Tubal Patency

Fallopian tubes are an essential part of the reproductive system, and their health is an essential part of the discovery process. Fallopian tubes allow fluids and cells to go from the uterus to the ovaries. The health of that passageway is critical and can be assessed by tests such as a hysterosalpingogram (HSG). An HSG is a common test that uses x-rays to get a clearer image of your uterus and fallopian tubes. It can detect any blockages in the fallopian tubes or uterine abnormalities that may prevent an embryo from traveling safely and attaching to the correct area. 

Uterus

Many tests can determine the health of the uterus. From congenital abnormalities of the uterus to fibroids, your doctor must test the uterine cavity for optimal health. Tests can include a vaginal ultrasound, saline ultrasound, an HSG, a hysteroscopy, or a biopsy. If you plan to carry a fertilized egg (embryo) in your uterus for a healthy pregnancy and birth, identify and treat any uterine conditions. Your doctor will make sure nothing is preventing an embryo from implanting and growing in the uterus. 

Sperm

Fertility is very egg-centered, but we can’t forget the other part of the equation! Whether from a donor or partner, frozen or fresh, a semen analysis can tell us what we want to know. With a semen analysis, we can determine the sperm count, motility, morphology, and more. These are all important factors in the process of fertilizing an egg to become an embryo and the implantation of the embryo to become a healthy baby. 

Genetic Testing

Genetic Testing can be broken down into testing the parents and testing the embryo. For the parents, an expanded carrier screening is done to determine any genetic traits that are a match, thus increasing the chances of showing up in a child. This test compares around 275 genetic traits. Genetically testing an embryo is done through preimplantation genetic testing for aneuploidy (PGT-A). PGT-A searches for any extra or missing parts in the embryo’s DNA, so genetic health and viability of the embryo to implant is checked.

Immune Testing

Your immune system’s health is often overlooked when it comes to fertility. Luckily our experts make sure to integrate your reproductive health with your overall health, which means testing for any immunological conditions that could be a barrier to fertility. Immune testing is often looked at after any recurring implantation failures or secondary infertility; however, it can be proactively discussed with your doctor if any active conditions are contributing to infertility. It is vital to discover the root cause of infertility, even if the condition is seemingly unrelated to your reproductive functions. Our work is to look at you as a whole person and not just your symptoms. 

Testing your fertility is a valuable tool that helps narrow down appropriate fertility treatments. Each couple or individual is unique and requires a tailored plan. Fertility testing is the first step on that journey. These tests allow your doctor to pinpoint the root cause of your infertility. 

You don’t need to experience infertility to benefit from fertility testing. Until you start trying to conceive, fertility is often an unknown factor. Testing your fertility before you want to get pregnant can help you plan ahead. With fertility testing, you’ll learn more about your reproductive health. Proactive fertility testing can help you make informed decisions about treatments that protect your fertility such as egg, sperm, or embryo freezing. 

Whether you’re trying to conceive, or are planning for a future family, it’s natural to question whether you need fertility testing and what the process will be like. Let’s explore some common questions and concerns about fertility testing:

When You Should Test Your Fertility

Are you wondering whether you should test your fertility? We recommend that you test your fertility if you and your partner have been trying to conceive for 12 months without success. If you or your partner are over the age of 35, it’s best to seek fertility testing after 6 months of trying to conceive. For individuals over the age of 40, we recommend consulting with a fertility expert as soon as you want to try to conceive. 

That said, fertility testing can also be beneficial before you try to get pregnant. If you simply want to learn more about your reproductive health, fertility testing can help you plan for your future family.

Does Insurance Cover Fertility Testing?

Many insurance policies cover fertility testing and treatments. In some cases, fertility testing is covered, but treatments are not. When fertility treatments are covered, conditions may apply. For example, a certain number of IVF treatment cycles may be covered, or your policy may max out at a maximum dollar amount. 

Fortunately, in the state of New York, private insurers are legally required to cover at least a portion of your fertility treatment. Note that this is only true for large group insurance policies and contracts. In other words, if you work for a company with fewer than 100 employees, the law doesn’t apply.

Request and review your insurance policy to find out the benefits and details of your coverage. If your policy doesn’t include the fertility coverage you need, you may be able to get supplemental fertility coverage. Ask your employer to learn about any options available. 

Fertility Testing for Women

For women, fertility testing may involve many different tests. Doctors need to evaluate the many different factors that can affect fertility in women. 

Fertility testing in women often involves an evaluation of hormones. Your doctor may request urine and blood tests to detect hormones. Hormones influence reproductive processes, including ovulation or the release of the egg from the ovaries. Some hormones your doctor may test for include progesterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH). Testing these hormones can help determine whether you’re ovulating normally. 

An additional hormone test your doctor may request is for the anti-müllerian hormone (AMH). This hormone influences how well your ovaries work. Low levels of this hormone can mean that you have fewer quality eggs available. 

Your doctor may also examine your reproductive organs. Some common female fertility challenges related to organs include blocked fallopian tubes, endometriosis, or uterine fibroids.

Fertility Testing for Men

The cause of infertility in up to 20% of couples is related to a male factor. In 30-40% of couples, there is both a male and female factor involved. For this reason, it’s important for men to seek fertility testing. 

Fertility testing for men helps identify the underlying cause. Some common causes of male infertility include low sperm count, blockages, and poor sperm movement. One of the first tests for men is typically a sperm analysis. With this test, doctors will be able to see if sperm are present in your semen and how they behave. 

To check for blockages, your doctor may recommend an ultrasound. This can help your doctor see if sperm can move freely from the testicles to exit the penis. Blockages can occur in different places, and the ultrasound allows the doctor to check for this problem.

Other common fertility issues in men include hormone deficiencies, medication, varicoceles, and retrograde ejaculation. Your doctor may perform blood and urine tests, ask questions, and perform a physical exam.