An estimated 15% of all couples have difficulty conceiving, and if you've been trying for a baby for baby for over 12 months without any luck, it's probably time to visit your Doctor.
In many cases, a trip to the Doctor can be hugely beneficial, as there could be a clear reason why you've been unable to conceive, such as weight, age or problems with sex itself. I know it's embarrassing sharing the ins and outs (if you'll excuse the pun) of your sex life with your Doctor, but it's important to get everything out in the open so that your Doctor can determine if it's time to start fertility tests.
Just the phrase 'fertility tests' is usually enough to send many men and women into a frenzied panic, but there's really no need. Fear comes from the unknown, and in most cases couples are referred for fertility testing without knowing what's going to happen, or what's being looked for.
I hope to provide some information here as to the fertility test procedures undertaken for both men and women and what the Doctors will be looking out for.
There are 3 main categories of test that are performed initially on women who are finding it difficult to become pregnant, and you'll be happy to hear that only one of them involves flashing your 'bits'!
For most of us, blood tests are simple. For those with needle phobia, they can be a nightmare. But look at it this way, if you become pregnant, you'll be needing a lot more of these blood tests so you may as well get used to them now!
As you'll know if you've had blood tests in the past, the actual procedure is easy. Blood is usually taken from the inside of the elbow, in the crease where you bend your arm, and you may have a band tied tightly around your upper arm to make sure there's an adequate quantity of blood. You'll feel a sharp prick as the needle is inserted, but it really shouldn't be too painful. It takes literally seconds to extract enough blood to test, and then you'll be on your way. Simple!
There are usually 2 hormones Doctors will be looking for when examining this blood; progesterone and FSH (follicle-stimulating hormone).
FSH stimulates the ovarian follicles which house your eggs. When these follicles are stimulated, they mature an egg and release it into the fallopian tubes, which is where it's fertilized by the sperm. If our bodies aren't producing enough (or any) of this hormone, it's very unlikely that ovulation is occurring, and without ovulation, we can't get pregnant naturally.
Levels of progesterone will be looked at for a similar reason. When the follicle releases the egg, it continues to grow and produces progesterone as it's doing so. This progesterone is used to keep the uterine lining in place so that a fertilized egg can implant into the wall of the uterus. If there's suboptimal levels of progesterone, it could mean the ovarian follicle isn't growing as normal and may indicate a problem with ovulation.
Progesterone levels are usually at their peak around 1 week before menstruation, so you may find your blood test is scheduled for around this time to produce more accurate results.
This is the part that involves flashing your 'bits', but don't worry, it's no more embarrassing than going for your regular pap smear. It's no more painful, either, so if you can cope with that you should have no trouble coping with this.
The procedure will be familiar to most women who have already undergone a pap smear or an STI test. You will be asked to assume the very undignified position of lying on your back, with your knees open and bent up to your middle. The Doctor or Nurse will insert a speculum into your vagina to keep it open, and will then insert a swab (like a giant q-tip), usually up to the cervix. Some women feel a bit of pain as the speculum stretches the vaginal walls, but the swab itself doesn't hurt.
The swab will collect cells which will be looked over in a lab. What Doctors are looking for here is chlamydia; a sexually transmitted disease that usually does not present with any symptoms, and doesn't show up with a routine pap smear. Chlamydia can cause pelvic inflammatory disease (PID) which is a condition affecting the uterus, ovaries and fallopian tubes and can cause infertility.
Ultrasounds & X-Rays
Some women may be required to have an x-ray or ultrasound of the uterus to make sure there are no blockages in the fallopian tubes which could be preventing mature eggs from making the descent towards the womb.
X-rays and ultrasounds aren't painful, but in order to get a proper look at what's going on in there, you may need to have a dye injected into your veins. Unfortunately, this means a needle again. The brightly colored dye travels around the body in the bloodstream, and so can easily show if there are any blockages along the way. The dye is harmless and will come out the next few times you go to the bathroom (it turns your wee an impressive fluorescent yellow!), but some women may find they feel a bit lightheaded, nauseous or hot and sweaty during the procedure.
Fertility tests for men are much simpler than for women. Isn't that always the way? There are just 2 initial tests performed on men, and neither includes them having to go through the embarrassment of getting their private parts out in front of the Doctor. Very unfair!
A simple urine test for men can show up if he's ever had chlamydia. Chlamydia in men can affect fertility as much as in women, as it can cause an infection of the epididymis; the bit of the penis that transports sperm from the testicles to the head of the shaft. If sperm can't reach the egg, there's absolutely no chance of conception.
Many men find this test particularly embarrassing as they're asked to make a 'deposit'. As conditions need to be as sterile as possible so as results aren't affected, this usually needs to be done in a healthcare environment which, as you can imagine, isn't the most relaxed or sexy of settings. Usually, 'aids' are provided in the form of magazines to help things along.
Doctors will examine the sample to check the quantity, motility and health of the sperm. A low sperm count can reduce the chances of sperm reaching the egg, as can low motility. Sperm that are abnormal may not be capable of fertilization.
Medical advances mean that even if couples are diagnosed with infertility, there's still a very good chance that they will be able to have children. Some couples are even able to have children that are biological to both parents.
The next step really depends on what the cause of infertility is. For example, if ovulation is the primary cause, women may be given hormones to try and encourage the release of an egg, or if there's a fallopian tube blockage, an operation to remove the blockage may be available.
It's important to realize that a diagnosis of infertility from medical fertility tests is not the end of the world; it simply means that you're now able to do something about it. Fertility tests aren't scary, and they don't make you a failure, they put you in a position to be able make decisions about your future.