Fertility work up - what test I need to ask from my GP

I am often asked by couples what western medical test are needed to have their fertility evaluated.

I have asked one of our local RE's from Gensis to answer this question and also to briefly explain why where not self explanatory.  Hopefully they will also explain when you should go for testing based on age and medical conditions. - Lorne Brown, Acubalance Wellness Centre (www.acubalance.ca)

You can print their suggestions and take it to your  medical doctor. 

Response from Dr. Jason Hitkari, MD (Reproductive Endocronologis)

It is my pleasure to answer this post as it is important for people to know when it is time to start to investigate why they may be having trouble conceiving.

In general, I teach family doctors and gynecologists to start investigating after a year of trying in patients where the woman is <35 years of age.  Those couples who are trying where the woman is >35 years of age should have investigations done after 6 months of trying because of concerns over time.

The "Western" fertility work-up is pretty straight-forward.  It should be noted that I see many couples who are just interested in getting the work-up without considering fertility treatments.  That is important- just because you see a western fertility doctor doesn't mean that you necessarily need or want treatment.

We basically try to address the "ingredients" of pregnancy.  This includes the following:

1.  Day 3 FSH and estradiol testing - this tries to ensure that the ovaries are still acting "young" and that the eggs present in the ovary are still of good quality

2. Thyroid and lactation hormone (prolactin) testing on all women

3. Semen analysis

4. A hysterosalpingogram - this is an x-ray of the uterus and fallopian tubes to ensure that a woman's anatomy is normal

At Genesis, we also tend to test the woman for things that should be known before getting pregnant such as whether either person in the couple has HIV, hepatitis B or C.  We also test the woman for immunity to Chicken Pox, Rubella and Syphilis.  Some of these are mandated for us to do.

These tests can be easily done.  The only one that can be tricky for patients is the hysterosalpingogram because this is not a pleasant test in that it requires a speculum and can be a crampy for patients.  I will say, however, that the information from this test is crucial.

I hope this helps,

Dr.Hitkari

www.genesis-fertility.com