What tests do they run for fertility?

Question

I have been TTC for over a year and I’m currently having very irregular cycles, even under the care of a gyno. When I go back to her at my next appointment, I want her to test for fertility- what if I don’t even have the ability to get pregnant? I want to know now as I am 31. I have never caught a positive opk, although I admit I do it inconsistently due to my body skipping periods. 
What tests do they typically run? Egg reserves? Follicles? I am pretty naive and do not really understand the standard tests, can anyone tell me from experience?
Thank you!

Answer

If you just go through your OB they will do basic tests. Usually they will test your blood for your TSH, FSH, progesterone, etc. Your OB can also order an HSG and semen analysis. 
If you want a real diagnosis you need to see a fertility dr. My OB did as many tests as she was allowed to do and according to her I was healthy and there should be no reason I shouldn’t be able to get pregnant. Little did she know I had endometriosis and required IVF. You can get a referral for an RE through your OB, so I’d go that route. My RE did regular follicle/endometrial lining ultrasounds as well as monthly bloodwork for progesterone, estrogen, etc. She ordered a dna fragmentation test for my husband’s sperm (different from a regular semen analysis), as well as follow up regular semen analysis tests after he had been taking her recommended supplements for 3+ months. She performed a hysteroscopy and an endometrial biopsy. During my hysteroscopy she removed some polyps and tested them for cancer. If you’re not ovulating they will probably test you for PCOS. Some women also get tested for autoimmune disorders. There are endless tests available for infertility!

Answer

You really need a fertility specialist to run a full work up and interpret what they mean for your chances of conceiving naturally or else what treatments they would recommend. Some are simple blood tests, but there are also procedures/imaging that can be really
important to get the whole picture. Anecdotally - my OB had no concerns whatsoever with my husband’s sperm results (very low morphology)…..which was the main factor that led to us needing IVF. Our fertility doctor was able to give us a more realistic outlook, because it’s her area of expertise.

What tests do they run for fertility?

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