The best way to get to the bottom of your difficulty getting pregnant is to have all the facts. After your first meeting with your Fertility Specialist, the first step is to have a few routine tests and procedures to spot any specific issues so we can be fully briefed to develop your personalised treatment plan. Male testing is also conducted so both partners are reviewed closely. These tests are key as they ensure the treatment selected addresses your specific fertility issue. Your GP may also order these tests before deciding whether to refer you on to a Fertility Specialist.
There are a few blood tests your doctor might order. Don't worry, the majority of these can all be done in one blood collection appointment.
Anti-Müllerian Hormone (AMH)
AMH is secreted by cells in the follicles of an ovary and is used to indicate ovarian reserve (aka the number of eggs you have). It’s important to know that the AMH test cannot give any information about the quality of eggs, it is helpful for personalising your fertility treatment. The test can be conducted with a blood sample at any time in your cycle.
Follicle-stimulating Hormone (FSH)
Follicle-stimulating hormone (FSH) helps control a woman’s menstrual cycle and the production of eggs. Testing FSH levels can also help your Fertility Specialist evaluate your ovarian reserve, particularly when there is a significant problem. It’s most likely your doctor will want the test to be done on the third day of your menstrual cycle.
Luteinizing Hormone (LH)
Luteinizing Hormone (LH) is linked to ovarian hormone production and egg maturation. Your Fertility Specialist can test your LH to see if and when you are ovulating.
Oestradiol (estrogen) is an important form of oestrogen (the primary female sex hormone). Oestradiol is produced by ovarian follicles as they grow, and it develops/thickens the lining of your uterus. Your Fertility Specialist will use an oestradiol test as part of an assessment of ovarian function. It’s likely to be conducted on the third day of your menstrual cycle and is also an important part of monitoring of fertility treatments.
A week after expected ovulation, your Fertility Specialist might test your progesterone level. Progesterone is the hormone which is produced by your ovary after you ovulate. It helps maintain the endometrial lining making it a receptive environment for a fertilised egg.
Probably best known for its role in human milk production, an elevated level of prolactin at other times can be associated with poor or absent ovulation. Your Fertility Specialist may use a prolactin test to help understand why you’re not menstruating or ovulating regularly.
Your thyroid gland (FYI – it’s found in your neck), produces thyroid hormone that regulates your metabolism. An over or underactive thyroid function can lead to widespread medical issues and problems with ovulation. But more commonly, it leads to a very subtle change in thyroid function, especially mild underactivity often as a result of thyroid antibodies, can lead to fertility problems and a higher risk of miscarriage. Your Fertility Specialist will often measure your thyroid gland’s controlling hormone (TSH) and look for thyroid antibodies.
If you and your partner have experienced recurrent miscarriage or one or both of you have a genetic condition in your family, your Fertility Specialist may review both partners for chromosome abnormalities. If the blood tests detect abnormalities, your Fertility Specialist might discuss with you our genetic screening and testing options - Pre-implantation Genetic Diagnosis or Pre-implantation Genetic Screening.
Even without any obvious family history, anyone planning pregnancy should consider having testing to ensure that you don’t carry the same quiet genetic (recessive) condition as the person you plan to get pregnant with. Many of us carry one recessive condition which in itself doesn’t cause disease, however, if both people carry the same recessive gene (examples include cystic fibrosis and spinal muscular atrophy) – then you have a 1 in 4 chance of having a baby with a serious medical disorder. Your Fertility Specialist will offer this testing which is undertaken by an external pathology company.
An ultrasound helps your Fertility Specialist to check the health of the lining of your uterus (called the endometrium) as well as check for fibroids, polyps or ovarian cysts and conditions such as endometriosis and polycystic ovarian syndrome (PCOS). When combined with hysterosalpingo-contrast-sonography (HyCoSy), an ultrasound will check that your fallopian tubes are open and not blocked.