Basic fertility test
At New Fertility Group Madrid, we perform a basic fertility test in a single visit.
What is infertility?
Infertility, as defined by the WHO (World Health Organization) and ESHRE (European Society of Embryology and Human Reproduction), is “the inability to conceive after a reasonable period of sexual intercourse without contraceptive measures.”
In women under 35, we should consider a fertility problem if they have not been able to conceive after trying for approximately one year. Unfortunately, the rate of female infertility has increased in recent years, as women are increasingly having to postpone their childbearing age.
What does the fertility study test consist of?
Through a transvaginal ultrasound, we check the normal functioning of a woman’s internal genital system. This ultrasound examines the morphology of the uterus (we can rule out many uterine malformations, or the presence of endometrial polyps, fibroids, etc.); it also visualizes the ovaries (size, characteristics, presence of ovulatory signs if the ultrasound is performed mid-cycle, etc.).
Thanks to this test, we can detect certain diseases or different types of cysts, some of which (such as endometriotic cysts) can negatively affect fertility.
Furthermore, ultrasound allows us to assess the number of antral follicles (which contain eggs) and thus obtain information about ovarian reserve.
Hormone tests for infertility are performed at two points in the cycle: on cycle days 2-3 and 19-21. Ovarian and pituitary hormone levels undergo a series of changes throughout a woman’s cycle, and therefore, to determine whether they are normal or not, they must be measured at the same times for comparison. The hormones typically measured are follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, and thyroid-stimulating hormone (TSH).
Tests performed in the early days of the cycle (basal tests) provide information about ovarian reserve. Hormone tests performed on cycle day 21 determine whether ovulation is occurring.
This test also allows us to detect some luteal phase abnormalities, such as luteal phase defect or hyperprolactinemia.
The semen analysis, or sperm analysis, is a very simple test used to perform a basic semen analysis. It primarily measures the following parameters: sperm count, sperm motility, and the percentage of sperm with morphological abnormalities.
The results of these tests allow us to determine the cause of infertility in approximately 80% of couples. At the same time, this simple study allows us to guide the couple toward the most appropriate assisted reproduction treatment for their case.
In other cases, additional testing may be necessary before starting treatment.
If the results of the above tests, which we consider routine or common to all patients, are inconclusive, the study would continue with various types of additional tests. The variety of complementary tests within fertility studies is enormous. Many of them are very complex and specific tests that are only useful for diagnosis in a few cases.
Physicians typically order additional testing as a patient’s clinical situation warrants, based on the specific needs and circumstances of each case, whether due to the detection of signs of a specific pathology or to clarify the inconclusive result of a basic test.
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Frequently asked questions about our fertility test
In a fertility test, what does normal fertility mean?
In fertility testing, we consider it normal for a woman to take up to a year to become pregnant. This may seem like a long time, but it’s the reality revealed by fertility studies.
One of the determining factors in a woman’s fertility is age. By the end of the first year, between 80 and 90% of women under 35 will have successfully conceived. However, between the ages of 35 and 40, the percentage of pregnant women by the end of the first year does not exceed 70%. When a woman is over 40, this percentage drops to 20%. When a woman exceeds these aforementioned time frames, we can talk about the existence of female infertility and she should consult a specialist.
What is the difference between 'infertility' and 'sterility'?
The difference between “sterility” and “infertility” is that, in the former case, the woman has never managed to conceive. In contrast, a patient with infertility achieves or has managed to conceive, but the pregnancy has not culminated in the birth of a live child (as occurs, for example, in a case of repeated miscarriage).
Infertility and sterility are two terms that, although they lead to the same problem—that a couple cannot conceive a child—are completely different, as are their causes and treatments, as can be seen in the fertility assessment.
Is it the same problem if I don't get pregnant as if I do and miscarry?
No, they are different problems. Not getting pregnant indicates difficulty achieving conception, while a miscarriage occurs when a pregnancy is lost after it has begun.
The causes are different, and therefore, so are the tests and treatments. If pregnancy is not achieved, a fertility test is usually performed to identify possible causes and guide appropriate treatment.
When should I be concerned?
When should I see an Assisted Reproduction specialist and undergo a fertility test?
Which specialist is right for my fertility problem?
The doctor with the appropriate training to perform fertility testing, diagnose, and treat infertility is a gynecologist specializing in reproductive medicine. After conducting a detailed medical history, a basic fertility study is performed in most cases. However, when the diagnosis is clear from the medical history, additional complementary tests may be ordered initially.
The reproductive medicine specialist will be able to determine the causes of the sterility and infertility problem and conclude whether the problem is female, male, or mixed. Once diagnosed, the most appropriate treatment will be prescribed based on the causes of infertility or sterility identified.
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