Trying For Baby For More Than Six Months

During your first consultation, the fertility expert will try to understand your issues with the help of detailed medical and personal history. The doctor will also recommend a few tests for you and your partner to access your fertile health, understand the cause of pregnancy delay, and devise the best treatment plan suitable to you. Let's now try to understand what all tests you and your partner will be undergoing for baseline fertility assessment.

During your initial appointment, the fertility expert will try to understand if you are having any hormonal issues, which might be causing menstrual delay or absence of menstruations. Menstruation is a bodily activity of reproductive age women, which happens regularly to release eggs from the ovary (ovulation) every month.[2] If the woman's egg gets fertilized with the sperm and attaches itself to the uterus lining to grow, pregnancy is confirmed. If the egg is not able to meet the sperm, your periods will start. You can read more about menstrual irregularities here.

Hormones like progesterone and estrogen play a vital role in maintaining your menstrual health and regulating ovulation. However, certain medical conditions like polycystic ovarian syndrome and thyroid malfunction can off through your hormonal balance and cause menstrual irregularities causing the delay in your pregnancy.[3]

Apart from hormonal imbalance, the doctor will also check for other medical issues like endometriosis (a condition where usual uterine lining - endometrium grows out of the uterus) and blocked fallopian tubes that can negatively impact your chances of pregnancy. The doctor will also check the medical and reproductive health of your partner. The fertility expert will also recommend some tests to both of you based on your initial assessment. Let's now learn the various tests your doctor might recommend you during your fertility visit.

As discussed earlier, the fertility expert will recommend some tests along with a transvaginal ultrasound scan before suggesting any fertility treatment. The ultrasound scans help the doctor to evaluate the uterine lining and uterus abnormalities. Other tests that your doctor may recommend are-

1) Anti Mullerian Hormone Test - Measuring anti-mullerian hormone level in your blood provides an estimate of your ovarian reserve.[4] If you are undergoing IVF, your doctor will also suggest an AMH test during the IVF cycle to check how well you are responding to ovarian stimulation drugs for in vitro fertilization (IVF) treatment.

2) FSH and LH test - The doctor will recommend a combination of FSH and LH test to learn if your ovaries are working accurately and you are ovulating.

3) Antral Follicle Count - Before suggesting any specific treatment, your doctor will check your antral follicle count (AFC) on day 2,3 or 4 of your menstrual cycle. These follicles are the structure that contains the eggs. With the help of a total AFC count, the doctor can predict your response for the IVF cycle. Your doctor may recommend an AMH test, FSH test, and antral follicle count test together as it gives a better understanding of your ovarian reserve.

4) Tests to check thyroid functions - Your doctor will also recommend a free thyroxine test and thyroid-stimulating hormone test to check the functioning of your thyroid gland. The thyroid gland releases hormones that help in regulating menstrual health. Too much or too little of these hormones can cause menstrual irregularities.

5) Hysterosalpingography - It is an X-ray procedure with the use of contrast dye to check the health of your fallopian tube. The test will show if you have any blocked fallopian tubes.

The fertility doctor will recommend a semen analysis test for the men. During the semen analysis test, the doctor will look at the sperm count (sperm per ml of semen), sperm motility, and morphology (how efficient is sperm movement and the shape/size of sperm) along with PH levels, presence of immature sperms and blood cells (if any). If the semen analysis test results are abnormal, your fertility doctor will likely suggest hormonal tests to understand the testosterone level.

In short, the doctor will try to identify if there are any problems with male fertility, which may be causing your delay in pregnancy.

If all your tests come out negative, and fertility expert thinks that your reproductive health is good. He may recommend some lifestyle changes, fertility-boosting supplements, and fertility drugs to help you ovulate. The doctor will also help you understand about your fertile days and ovulation cycle to help you conceive naturally. Whereas if your test results are showing any medical issues with you or your partner, that might be preventing you from getting pregnant. Your doctor may recommend some artificial reproductive technologies like IVF and IUI to help you conceive. In the case of IUI treatment, the male sperms are manually injected in the female uterus near to the fallopian tube, so that the sperms have to travel less, this increases the chances of successful fertilization considerably.

Even though IUI increases your chances of conception, it is still less than the chances of conception with IVF. In cases like blocked fallopian tubes, extremely low sperm motility, etc. the fertility expert will recommend IVF treatment. During IVF treatment, the egg and sperms are retrieved and fertilized in a laboratory. After fertilization on day three or day five, the embryo will be implanted in your womb to grow to full term.

If you are still confused about how to start your journey towards a healthy pregnancy talk to our care team @ 636-636-3030 and we will guide you at every step.