Couples often feel overwhelmed when struggling to have a baby, and when the months add up to years of trying to conceive, the frustration can become intense. Despite these feelings, it’s common for couples to procrastinate around seeking medical help. Yet as fertility specialists, we often hear from our patients, “I wish I came to you sooner.”
As it turns out, fear of the unknown often holds couples back from seeking help. For this reason, our goal is to break through that barrier, making both the fertility testing and treatment process as easily understood as possible. When we boil things down to the basics, it’s clear that there’s nothing to fear, and that seeking assistance from a fertility specialist can potentially be the best move for you in your journey to parenthood.
When first seeking help, your fertility specialist will typically conduct fertility testing (also referred to as “fertility evaluation”) to help determine any underlying causes for your reproductive challenges. Fertility testing can be broken down into four categories that help to examine different parts of the body that play critical roles in the reproductive process: the ovaries, the tubes, the uterus, and the sperm. Let’s take a closer look at the testing process for each area:
Because women are born with all the eggs they will ever have, they lose them as time goes by. The process of egg loss cannot be stopped, and even when on birth control, or when pregnant, a woman continues to lose her eggs. Therefore, we rely on important bloodwork that helps us understand what is going on in a woman’s ovaries. Specifically, this bloodwork examines two hormones: FSH and AMH.
FSH provides insight regarding the month-to-month egg supply, while AMH offers a way to evaluate the overall egg supply. FSH can fluctuate over time, while AMH generally remains constant. Your specific level of each hormone will provide valuable information to your physician regarding the current state of your egg supply.
The fallopian tube test (known as HSG – hysterosalpingogram) is done in the office setting or in a local radiology department. This involves a small catheter that is placed in the uterus. The tubes are then flushed with liquid delivered by the catheter, allowing us to see if both tubes are open. This is important because fertilization takes place in the fallopian tube. If a tube is blocked, conception becomes difficult, and may put the mother at risk for an ectopic pregnancy (i.e., a pregnancy that implants in the fallopian tube instead of the uterus).
Your uterus is where your pregnancy takes shape – and so it’s crucial to understand the health of this vital reproductive organ. Tests to assess the uterine cavity involve either a saline infusion sonogram (SIS) or a hysteroscopy. Both tests are used to confirm there are no polyps, fibroids, scar tissue, or other uterine anomalies. During this process (either in your fertility provider’s office or at a local surgery center setting), a small catheter or camera is inserted gently into the uterus, and salt water is instilled. An image is viewed either with an ultrasound or TV to confirm a normal uterine cavity.
A semen analysis is the test done to assess a man’s sperm, reviewing the overall volume, concentration, motility, and percentage of normally shaped sperm. Each of these characteristics are important to ensure proper functionality of the sperm, as it makes its way to fertilize a woman’s egg(s). However, it is common for couples to ignore this test, which can be a major oversight, given that male factor infertility can be an issue as high as 40-50% of the time.
Fertility testing may sound overwhelming but is relatively easy for the patients involved. For example, most women comment after testing that the tube and uterus tests were not “as bad” as they worried it would be, further demonstrating how important it is for patients to not let fear hold them back from seeking help. Understanding what underlying conditions exist can help trigger the most appropriate treatment course to achieve your goals.
The American College of Obstetricians and Gynecologists recommends fertility testing with a specialist if any of the following apply to you:
However, if you have a known problem, such as irregular periods or endometriosis, we recommend that you do not wait the full year to undergo testing. In general, it can only benefit you to save time and be proactive. Also remember that the sooner you see a specialist, the sooner they can help.
While fear of the unknown can cause avoidance in seeking medical help, we also understand that fear of knowledge of what could be wrong can also be a barrier. Many individuals are simply scared to learn there is something abnormal with their bodies. However, understanding the source of your infertility is the first step to being able to overcome it!
We urge you to not wait in seeking help. Fertility specialists work with a variety of complex cases every day, and can work with you to understand your body, provide education on treatment options (see our post on IVF to learn more about one of the most common treatment courses), and administer care to help lead to your ultimate goal of a successful pregnancy. Good luck!
To schedule an appointment with Dr. Budinetz, call (215) 887-2010.