Fertility testing: advanced tests for women and men

Same diagnostic methods cannot be applied to all patients, this is the reason why our clinics offer a patient-centered fertility study. After conducting an extensive interview and taking into account the patient personal characteristics, the doctor will assess which are the most appropriate examinations for each case

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In Reproductive Medicine it is very important to individualise each patient, as each one may have a different cause of infertility. That is why, after a complete and extensive evaluation of each case, the doctor will assess which are the most appropriate tests.

When to start the study?

It is recommended to start with the study if pregnancy has not been achieved after one year of sexual intercourse without the use of any contraceptive method and there is no medical history of risk of infertility. On the other hand, in couples over 35 years of age, we should start this study after 6 months of unsuccessful search. In any case, it is advisable to have an assessment with a gynaecologist specialising in fertility before becoming pregnant in order to receive correct information on family planning.

How to know if I am fertile?

There are a number of tests that can help us find out if we have a problem having children.

Basic Fertility tests

The basic tests for the diagnosis of infertile couples consist of carrying out a complete medical history including family and personal history, gynaecological and andrological history, lifestyle, exposure to toxins, etc., and is completed with a series of tests:

Hormone analysis in women. We measure the hormones regulating ovarian function (FSH, LH, Estradiol, Progesterone) in the first phase of the cycle; and on the other hand, we measure the anti-mullerian hormone (AMH) that determines the ovarian reserve. The latter can be measured at any time during the cycle.
High-resolution or 3D vaginal ultrasound: this allows for a detailed study of the uterus, ovaries and pelvis. It is essential for detecting uterine anomalies and malformations, the presence of tumours and cysts in the uterus, tubes and ovaries. On some occasions it can be completed with a:
Hysterosonography to rule out tubal obstruction, which can be a cause of female sterility. This examination avoids radiological tests with the use of contrast, eliminating both the need to be irradiated and the risks of the use of contrast. In addition, the use of three-dimensional technology makes it possible to rule out small malformations or uterine anomalies during the examination, completing the study of the uterine cavity.
Seminogram or spermiogram: this is the analysis of semen. We first study the characteristics of the seminal plasma and the quantity of spermatozoa, their mobility, vitality and shape. Given the great variability of semen samples, it is advisable in many cases to perform at least two.

You can learn more in the section: first fertility visit at Instituto Bernabeu.

Are there any other diagnostic tests?

In many cases, the basic study is enough to find the cause or causes of the problem and start treatment, but it is not rare to perform more specific and advanced fertility tests, not routinely in all patients, but depending on the results obtained in the basic study.

Sometimes the test results are completely normal. In fact, this occurs in 20-30% of couples tested. In these cases, we speak of infertility of unknown cause. It does not mean that there is no problem, but that it has not yet been found and requires the help of other diagnostic techniques or even the IVF laboratory to find out causes that lie in the quality of the oocytes, live fertilisation, abnormalities in fertilisation and/or embryo development and the quality of the embryos, among others.

Once the tests have been carried out, the gynaecologist explains the results obtained in detail. The different treatment alternatives that can be applied in each case are explained and a personalised therapeutic plan is designed.

In almost all cases, reproductive treatment is initiated immediately, starting with the woman’s next cycle if she wishes.

Before starting the cycle, it is imperative by law to request serological tests to rule out infectious diseases in accordance with each country legislation.

Are fertility tests available in pharmacies?

In pharmacies you can buy tests to determine some of the parameters involved in fertility, known as self-tests. These tests are easy to use and can be carried out at home.

There are 2 types:

Ovulation test: This self-test determines a hormone called LH and is carried out in urine (just like the pregnancy test). This hormone rises significantly in the 24 hours prior to ovulation. When the test is positive, it indicates that the next day or so we will have an egg ready to be released and therefore able to fertilise. The day of the LH determination varies according to each cycle and each woman, depending on whether we have short, long or irregular cycles and it may not always be easy to determine the LH peak.
Male fertility test: this self-test is aimed at determining sperm concentration. It is performed using ejaculates and with a previous abstinence of 2-3 days. Although male fertility tests can be up to 95% accurate, we must bear in mind that besides sperm concentration, there are other parameters to see the sperm quality such as mobility, volume, normal shapes, among others that cannot be determined with this type of test.

Although there are tests in pharmacies that can help us at some point, it is advisable to go to a reproduction centre to evaluate the set of tests, given that there are many other factors that cannot be evaluated with self-tests.