How can I test my fertility?
The female fertility is assessed by looking at the ovarian reserves, the ovulation and checking for the fallopian tubes.
The ovarian reserves can be assessed by a combination of blood test and the ultrasound scan. The blood test involves checking for the antimullerian hormone (AMH), they also include checking the follicle-stimulating hormone (FSH) levels, which is usually done in a combination with oestrogen levels to reach a valid result.
The ultrasound involves measuring for the very small follicles or what we call as an antral follicle and this count is known as an antral follicle count (AFC). So the ovarian reserve assessment is done by a combination of these blood tests and an ultrasound scan to understand the full picture.
Next moving on to checking for ovulation. The ovulation is tested by measuring progesterone levels. This is done a week before the expected period. Generally, it is known as a day 21 progesterone test because it’s presumed that every woman has 28 days cycle, which is really not the case.
Checking for the fallopian tubes and walls doing tests like Hysterosalpingogram or Hycosy or sometimes it is recommended doing a laparoscopy and dye test which is also known as a Lap and Dye test. Hysterosalpingogram and Hycosy are the outpatient procedures; they are screening procedures and one of the first steps that you would have to undertake if you’re trying to assess the basic fertility of the woman.
These tests involve going through a gynaecological procedure very similar to the smear test. A catheter is placed into the uterine cavity; a contrast dye is slowly instilled through the catheter into the uterine cavity. This dye flows through the tubes and spills from the far ends of the tubes, and this filling and spilling confirm the patency of the tubes. These are outpatient procedures, they may be a little bit uncomfortable.
The going through a laparoscopy or Lap and Dye is a keyhole surgery. It involves a day surgical procedure for which you will be put to sleep. You may have to take a couple of days off and the recovery time can be few days to one week. However, it is recommended to patients where they may be coexistent risk factors for infertility such as endometriosis or a past history of a chlamydia infection, or pelvic inflammatory disease.
So assessing for ovarian reserves, ovulation and the fallopian tubes forms the basic assessment of female fertility.
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