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Women’s Fertility Testing: What You Need To Know Before Doing It?

Women’s Fertility Testing: What You Need To Know Before Doing It?

What you need to know about your fertility testing?

Being fertile—able to conceive and/or sustain a pregnancy—is something we assume we are able to do by default. Consequently, we spend years on contraceptives to avoid pregnancy, thinking we can become pregnant the old fashioned way at any time and point.

However, the fact is one in six women will experience a fertility challenge and will need medical help in order to become pregnant. The realization that fertility is not a default state for many women usually comes as a surprise. It is not until we are unable to naturally become pregnant that we start asking questions: Do I have a fertility challenge? Why didn’t anyone suggest testing before?

The option to test women for their fertility potential has been available for some time. Fertility testing is usually done using the following three methods:

  1. Blood work: measures specific hormones on specific dates of the menstrual cycle. These hormones include: follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and progesterone (P4). Another blood test, anti-mullerian hormone (AMH), indirectly estimates the remaining egg supply.
  2. Contrast X-ray called hysterosalpingogram or HSG: looks for potential blockage(s) in the fallopian tubes - where the fertilization of an egg by the sperm occurs.
  3. Ultrasound of the ovaries: measures the total number of follicles (egg-producing microscopic cavities) in each ovary to estimate the number of remaining eggs.

It is important to note that none of the available fertility tests can measure the quality of your eggs. Current fertility tests can only indirectly measure your fertility potential by evaluating three factors:

  1. If there is a physical blockage that prevents fertilization.
  2. If there is an abnormal level of hormones in your menstrual cycle that may affect proper egg maturation.
  3. If there is a diminished total number (quantity) of your eggs for your age group (independent of their quality).

Some important questions regarding fertility testing:

  1. What is the purpose of these tests? Fertility testing can be done for screening or diagnostic purposes. Meaning, the types of fertility tests ordered and performed are different for someone who has been trying for a few months to conceive (and the diagnosis of infertility is being considered) versus someone who is simply checking their fertility potential at a random stage in their life.
  2. Who orders the tests? Comprehensive fertility testing is only done at fertility clinics which house reproductive endocrinologists. These experts are OB-GYN physicians who have had an extra 3 years of training in order to specialize in diagnosing and treating infertility. In the US, OB-GYNs can order fertility tests but often prefer not to because they are not trained in the diagnosis and treatment of infertility disorders. This poses a problem as OB-GYNs are the doctors we visit on a regular basis to discuss contraception, sexually transmitted diseases, and pregnancy but with whom we somehow avoid talking about how to become pregnant when we want to.
  3. Who pays for testing? Fertility tests are usually not covered by health insurance and thus can be very expensive out-of-pocket costs. While the visit and tests ordered through the OB-GYNs are usually covered by health insurance, visits and treatments (as well as tests) ordered and performed by reproductive endocrinologists at fertility clinics are often not covered by health insurance, making them out-of-pocket expenses.
  4. How are testing results interpreted? As fertility tests are only an indirect measurement of one’s fertility potential, the types of tests done and their subsequent proper and correct interpretation are crucial to ensure that the correct information is received. An experienced reproductive endocrinologist is the most qualified authority to convey implications from the right testing.

Home fertility testing has recently become available through three consumer-focused companies: EverlyWell (, Future Family (, and Modern Fertility ( These blood-based fertility tests can be ordered online, are offered for fertility screening purposes only, and are in no way intended to make any infertility diagnoses despite their ability to indicate abnormal hormonal ranges in some cases. Thus, these consumer-focused home fertility tests can lead to unnecessary anxiety, stress, confusion, and the need for repeating the same tests at a physician’s office in order to be interpreted correctly.

Opionato was created to help you interpret, understand, and assess your fertility test results for you and your partner, while also offering next-step advice in your fertility journey. Please write to us at [email protected] to start the conversation with one of Opionato fertility experts.

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