What Does Fertility Testing Involve?
Initial fertility testing may be done by your gynecologist or urologist. If further testing is indicated, you will likely be referred to a reproductive endocrinologist. Your partner may need to see their respective healthcare provider for testing as well. Fertility testing involves laboratory tests (blood tests and semen analysis), image testing (such as ultrasounds) of you and your partner’s reproductive organs, and other procedures to test the functioning of your reproductive system. Tests specific to biological females include blood tests to check hormone levels, thyroid functioning, and ovarian reserves; ultrasounds of the uterus and ovaries; and tests like hysterosalpingography and sonohysterography, which use imaging techniques to check the functioning of your reproductive system. Fertility tests for biological males involve semen analysis and ultrasound imaging of the scrotum and testes.
What Are the Most Common Fertility Tests for Couples?
Fertility tests for couples are important and often overlooked, says Julia Wilkinson, a certified genetic counselor at Invitae. “Oftentimes we see people think of ‘fertility’ as just a female issue when in reality, it’s incredibly important that both partners are tested and involved,” Wilkinson describes. Fertility testing for couples is a way for both partners to be involved at the start of their fertility journey, says Wilkinson, and these tests can also identify any potential risks early on. Here’s what to know about the most commonly used fertility tests that involve both partners.
Genetic Karyotyping
Simply put, genetic karyotyping is a test that looks at your chromosomes. It is done by a blood test and is used frequently in fertility testing. “The test looks to see if there might be any rearrangements or problems with the chromosomes in either partner that could make it harder to become pregnant or harder to have a healthy baby,” Wilkinson explains. Jason Flanagan, clinical associate professor at the University of South Dakota, genetic counselor at Sanford Health, and reproductive health expert with the National Society of Genetic Counselors, says that genetic karyotyping may be used when certain risk factors are suspected. “Karyotyping is not a standard test for most couples unless there is a risk factor noted-infertility, miscarriage, low sperm count, or ovarian concerns,” Flanagan explains. “A genetic counselor can help you decide if and when a karyotype would be beneficial.” Sometimes genetic karyotyping will identify a fertility issue in either you or your partner. For example, karyotype testing can reveal a phenomenon known as chromosomal rearrangement, which can cause miscarriage, or Y-chromosome microdeletion, which can lead to low or non-existent sperm count. Depending on the results that are found, different methods will be used to increase the chances of a successful pregnancy. Flanagan says that a procedure called preimplantation genetic testing (PGT-M) can be done after an embryo is created for IVF to ensure that the embryo doesn’t have any genetic issues that may decrease its viability. Additionally, sperm or egg donors can be used if karyotyping tests uncover issues.
Carrier Screening
Carrier testing involves testing both partners to look for genetic diseases that could be passed along to your children should you become pregnant. Carrier testing is not a fertility test, exactly, but it is usually done before any fertility treatments, such as IVF, are done. “Carrier screening does not equal fertility, but it does speak to someone’s risk of passing on a known genetic disease-causing genetic disorder,” explains Cindy M. Duke, MD, OB/GYN, a fertility doctor and virologist. Some of us are carriers of certain genetic conditions and diseases, but we don’t have these conditions ourselves, and we may not even have family members who have them, explains Wilkinson. “We often don’t know we are carriers until we have genetic carrier screening,” she says. For many of these conditions, both partners must be a carrier for the child to be born with the condition. Even then, you only have a one in four chance of having a baby born with the condition. Notably, carrier tests do not tell you for sure that your child will be born with the disease you are found to carry, only that there is a potential for this to happen. “It’s important to remember that while it is common to be a carrier of one or more conditions, it does not mean that your child will definitely have that condition,” explains Wilkinson.
Post-Coital Screening
Post-coital screenings are done soon after you and your partner have intercourse, usually at the midpoint of the menstrual cycle when a person is most fertile. A sample of cervical mucus is obtained and examined. Sperm count, motility, and activity may be noted. The idea is that looking at how sperm behaves in cervical mucus can paint a picture of your general fertility as a couple. However, post-coital screening isn’t used routinely anymore. It’s not something the American College of Obstetricians and Gynecologists recommend anymore, says Dr. Duke, and that’s because it doesn’t give reliable results. That said, some physicians still do post-coital testing. “It’s not very effective, but there are people out there who swear by it,” she says. Still, Dr. Duke explains, the majority of OB/GYNs don’t promote post-coital testing at this point.
A Word From Verywell
If your fertility tests reveal a potential problem, it’s understandable that you might feel upset or scared. It’s vital that you and your partner discuss your results with a genetic counselor or another healthcare provider so that you can fully understand what they mean. Further testing might need to be done to grasp the full scope of what is going on. Importantly, negative results aren’t always the end of the road. There are usually alternatives out there for you. Fertility treatments are always advancing and changing, and there is hope.
