Wondering what tests you should you do for your fertility?
Read The Fertility Expert’s 5-step guide to the different types of fertility testing, what they mean and how you can get them…
Your body speaks to you in many ways. The symptoms that your body experiences when something is going quite right is its way of communicating with you to let you know, “Hey something is not functioning right”! This is similar to the car you drive. If you need gas, the “low on gas” light turns red. If you body needs more gas you get tired and need to rest.
You get the point right?!
Hopefully when our body communicates with us we pay attention and do something about it. When you get tired as a means of doing something about it you may reach for “a pick me up” in the form of Caffeine, but is that treating the real problem?
Often this is your bodies way of telling you that something needs your attention. Instead of looking deeper to find out why you are feeling tired you may try the band aid approach first. But is that really fixing the issue?
I would say no.
Your fertility is much the same as the example I started with above. One of our main functions as human beings is to reproductive. In short we were made to have babies and populate the earth; so why is this easier for some and not for others? The answer to this question often begins with investigating why your body is having a hard time. This is your body communicating with you that something is wrong, and because something in your body is not functioning right you can’t get pregnant.
If we continue with the car example then this is your “CHECK ENGINE” light flashing on your dashboard.
If your car’s check engine light was flashing would you be ok if the mechanic told you that they could not figure out why this was happening? Unexplained fertility issues are very much the same thing.
They are telling you that they don’t know why you are having these issues but don’t worry you can continue to drive your car and we will just add some oil and change some spark plugs and see if that does the trick.
I wouldn’t feel comfortable letting my wife drive her car if someone could tell me what the problem was and why it was happening.
If you’ve been trying to get pregnant naturally, then testing your body’s ability to naturally conceive and get pregnant is important.
Lab testing is the proverbial pandora’s box. Once you open up this box the testing potential is endless and expensive. So where do you start? The first thing I want you to know is that I believe that 98% of you have not had enough testing. If your OBGYN, GP or REI tell you that they have tested “everything” I would ask 2 questions.
1 – Assuming you have not tested “everything”, what else can we test at this point to look deeper if you are telling me that all my results look normal?
Question #2 is more for those who have been told that they found a cause to your fertility struggles. Usually once they find a “cause” they stop looking.
2 – Now that we know about this problem, what other tests should we be running to get a better understanding about it or to see if this is affecting (or begin affected by) other systems?
Most often you have not had enough testing or your physician is proposing that you wait before you order tests because you are young, haven’t been trying for too long or you just don’t fit the criteria for ordering these tests. They are trying to squeeze you into a box.
I am suggesting that you control the size of the box that they are trying to put you into.
So with all that being said, here are the labs I suggest everyone start with. Obviously there are other tests that can be done depending on your health and reproductive history, but this is the foundational testing that I believe all patients should get done as early as possible in your fertility journey.
#01 Bloodwork – Day 3 Fertility labs: FSH, LH. E2, AMH, DHEA-s, Testosterone (both free and total), Prolactin, TSH, Vitamin D and progesterone labs on day 21 or 7 days post-ovulation.
#02 Dutch Test – This test is not the same are your fertility labs. This is a must for all my fertility patients as this test dives deeper into understanding your primary hormones and how they are being used by your body. As a bonus, it also will give you an adrenal profile, melatonin, oxidative stress markers and a small organic acid test.
Just as a heads up, you will need someone to interpret this test for you as it is not easy to understand. That being said, I think we all need a professional to review all our labs.
#03 Other labs – The above are certainly the place to start but if you have not had a full blood work done in some time then this is also a must. I would include a full CBC, Metabolic and Cholesterol panel. If you have any history of inflammation or if autoimmunity runs in your family, then taking a closer look at those markers is going to be important. I would start with: ANA, Homocysteine and CRP.
Again, it’s easy to keep ordering labs but this is just a starting point.
#04 HSG levels/Semen analysis – So no fertility work up is complete without an HSG for all the women and a Semen Analysis for all the men. These tests allow you to know if your fallopian tubes are open and working well or your partner needs a little love for his man parts. It takes 2 to tango so I don’t want to hear any of you men complaining about giving a sample to find out if your sperm are super duper or not.
#03 – Testing companies I recommend!
Here are some resources to getting these labs done on your own. I know we all would love to have our insurance cover the costs of getting these tests done but often they are not going to foot the bill. When this happens it is easy to just say no to more testing because it can be expensive and difficult to get done.
Because I believe you all should have control over your healthcare and fertility needs, and I also believe that you all deserve to have answers, I found some resources to make ordering these tests easy. Here are the companies I recommend you check out to get your labs ordered and get some real answers.
Want to find out for yourself what’s not letting you get pregnant and what to do about it? Then take these tests! These female hormone tests, ovarian reserve tests and other tests are the first start. They will be able to shed some light on what is going on with your reproductive and hormonal health, and fertility. I selected my favorite tests from Let’s Get Tested here. There are the MUST do I recommend to all my patients.
You order them online and take them from home – and receive the results 5 days later. If you’d like help understanding your results and finding out what they mean and what you should do, you should book a consultation with myself or one of my incredible Fertility Experts to have them reviewed and a fertility plan created for you.
Whether you’re years away from kids or thinking of trying soon, Modern Fertility will guide you through your fertility hormones now so you have options later. Modern Fertility makes fertility information available to women earlier in life – so we can navigate fertility, plan things out, and make sure we’re in the driver’s seat. The Modern Fertility experience includes a hormone test, personalized results that walk you through your ovarian reserve (how many eggs you have “waiting in the wings”), egg freezing and IVF, menopause timing and more, access to a weekly webinar (“egginar”), a 1:1 consult with a fertility nurse, and an invitation to a real talk community of women.
Depending on your insurance coverage, this same test offered in your OBGYN’s office can cost up to $1,500. By comparison, Modern Fertility’s test is $159. And just for the month of May, you can get a $10 credit towards the Modern Fertility test!
Once you have ordered and received the results for your tests comes the more challenging part of digging deeper into finding out the why. In many ways ordering the labs, now that I have given you these resources, is the easy part. What to do with the results is more challenging.
Last night I spoke to a woman who has consulted with 3 IVF docs and still needed me to help her figure out how to treat her NK Cell activity. The reality is that lab results can’t be looked at in a bubble. One result is influenced by others and can cause you to take a different course of action.
So briefly I want to breakdown the labs you are looking at to give some idea of what they mean. I am going to talk about these hormones in isolation because to talk about everything they can do and all the processes that they influence is too great to cover in this post. Just know that your hormones do more than what I am isolating out below, but these are the important points for you to understand as you get the results.
FSH – Follicle Stimulating Hormone is the hormone that signals to your ovary to start to grow and mature your follicles. Your eggs live inside your follicles, so think of this hormone as the one that tells your eggs to grow. This is a key marker for Egg Quality as well as other fertility related issues like PCOS.
LH – Luteinizing Hormone is key hormone that signals to the follicle that it’s time to release the egg. FSH and LH talk to one another so it is important to see how they are both doing in relationship to one another.
E2 – Estradiol is the main estrogen marker we look at. There are 2 others (E1 & E3) but I look at those when I order the DUTCH test. This hormone is important in the follicular phase of the cycle because without enough estrogen your cycles might be irregular and your follicles may not be of great quality. Additionally, with too much estrogen (estrogen dominance) you can have issues like PCOS, Endometriosis and a whole slew of other hormone related disorders. Estrogen also talks to your FSH so we want them done together.
AMH – Anti-Mullerian Hormone is the main marker for Ovarian Reserve. I can go on and on about AMH but I am not going to here. You can check out my other posts on AMH and Ovarian Reserve. The main thing you should know is that you want this number higher. So I like to see it between 1-3.
DHEA-s – DHEA is a precursor hormone to many of your other hormones like Testosterone and Estrogen. It is also an Adrenal Hormone. It is important to test because so many women use this supplement to address egg quality, but it is not something to take lightly. Taking too much can cause all sorts of androgen related side effects and cause your cycles to be irregular, or worse, disappear entirely.
Testosterone (both free and total) – Contrary to popular belief both men and women produce and need testosterone. This is a key marker to look for if you suspect PCOS.
Prolactin – This hormone increases when women are breastfeeding. It helps you produce breast milk. You can also see elevated prolactin with other pituitary issues which can certainly cause irregular cycles. It’s a must test when you check your hormones.
TSH – Thyroid Stimulating Hormone is the main thyroid hormone we check. It is actually not produced in your thyroid, but in your pituitary and it stimulates your thyroid hormones; hence the name. This is certainly just the tip of the iceberg when it comes to thyroid labs but it is the first place to start.
Vitamin D – more specifically D3. We want this tested for many reasons, because it influences so many systems, but I always want it checked when I test for AMH because it can influence your AMH reading.
Progesterone – This is a key hormone in your fertility process. Progesterone is the dominant hormone in the second half of your cycle (Luteal Phase) and helps to hold a pregnancy in the early part of the first trimester. It does so many other things as well and needs to be balanced with estrogen, but this basic understanding is sufficient to get your started.
Want to know what specific tests YOU need or need help understanding your results? Get a personalized fertility plan talking with us. We’re here to help you get pregnant >> CLICK HERE TO SCHEDULE A FERTILITY CONSULTATION
The other two tests that I want to cover here are your HSG and Semen Analysis. Yes, I did mention several others but this post is not the place to cover those details; then we will be getting into a blood chemistry class. The important thing to understand with those additional labs is that I do feel like we all need those to be tested. Then when you have all your results you should bring those all to your team of providers so your can get the guidance you need.
HSG – Hysterosalpingogram is also known as the dye test. This allows us to know if your tubes are open and functioning well. I often see this test left out, but if you want to conceive naturally then we need to know if your tubes are in working order.
Semen Analysis – All the prior tests have been for the ladies but this one is for the other half. I know that no man wants to ejaculate into a little cup…Yep, it’s awkward, strange, doesn’t feel the same and often you are doing this in someone’s office which makes it 3 times more uncomfortable. I know from personal experience, yep I had my little swimmers tested myself. Aside from having a blood test this was the only thing I could do so I wanted to experience as much testing as I could.
So yes, all those things I mentioned are true, but I don’t want to hear any complaining from all the men about doing this test. There is no test your wife or partner will do that will also allow them to orgasm! So it’s hard for me to hear men complain about giving a sample when they do experience some pleasure in the process.
Just get it done. The one important tip I will say is that you need to abstain prior to giving your sample for no less than 2 days and no more than 5.
So now that you have your lab results and you kind of know what they mean, what do you do next? For me the next step is to have a professional review your results so that you can get a clear understanding of what it all means and how to move forward with this information.
I am all for you working with your team of providers. So when you get this information back make sure you share this with all of them – Your OBGYN, your REI, your acupuncturist, your functional medicine doc or Naturopathic physician, and anyone else on your team. Each one of us will look at these labs differently and if you are looking for real answers then you want everyone to give you their thoughts.
It should not be a surprise if you get some conflicting opinions on what they mean and how to treat. Now it’s about filtering through all of that to create the right plan. This is where me and my team thrive. We combine Chinese Medicine, Functional Medicine and Conventional Reproductive Medicine to look at a patient’s results and history from an integrative perspective. This allows us to provide the most comprehensive plan so you get the results you are looking for in a timely manner and with minimal side effects.
If you want us to review your lab results, reproductive history and help you determine your next steps and plan then set up a call with me or one of my team members. >> click here to talk with us