Fertility has become a very hot topic these days with the surge in both assisted reproductive technology (ART) and adoptions.
ART typically consists of medications, intrauterine insemination (IUI) or in vitro fertilization (IVF) with the sole purpose of becoming pregnant.
In general, experts tell women under 35 years old to try regularly to get pregnant at ovulation for 12 months before considering additional work-up. Women between 35 and 40 years old should try for six months.
Whether you are in your first month or your first year without success, here are five tests to talk about with your doctor.
1. Follicle Stimulating Hormone (FSH)
Follicle stimulating hormone is the means of communication between the pituitary in your brain and your ovary. As the name implies, it causes the ovary to recruit and stimulate follicles leading to a main follicle that releases an egg at ovulation.
The higher the FSH, the lower the potential for follicle growth and stimulation because of low ovarian reserve (decreased ability of the ovary to produce eggs) leading to infertility.
Typically done on day 3, 4 or 5 of the menstrual cycle (meaning the first few days of your period) an ideal number is 10 mIU/ml or less. Double digits are more concerning, as far as chances go. Interestingly, blood type O is found in research to have a diminished ovarian reserve, whereas type AB has the best protection.
2. Anti-Mullerian Hormone (AMH)
Besides the FSH, the anti-mullerian hormone is also important as it too is a marker of ovarian reserve quantity and quality. Low levels mean low follicle count. High levels could mean polycystic ovarian syndrome. This test is also drawn early in the menstrual cycle, typically on day 3 or 4.
Progesterone is critical for prepping the uterus for implantation and maintaining the pregnancy the first several weeks until the placenta takes over. On a typical 28-30 day cycle, progesterone should be drawn on day 19, 20 or 21 and should be 7ng/ml or higher.