When you really think about the logistics involved, the fact that anyone ends up pregnant is kind of mind boggling. Not only does the timing have to be right, a man needs enough healthy sperm to navigate the treacherous journey to the descending egg, which then needs to make it to the uterus and safely implant itself. If anything goes wrong, no pregnancy will occur. Studies suggest that up to 15% of couples can’t conceive after a year of actively trying, which is the clinical definition of infertility (and that timeline shortens to six months for women older than age 35) (1). The thing is, no one really understands how common infertility is until they’re dealing with it themselves. That’s why some fertility specialists argue that fertility testing, a series of tests designed to identify potential hurdles to pregnancy, should be part of routine medical care for men and women of reproductive age. That’s clearly not happening currently, which begs the question: Why is it so hard to have your fertility tested?
Key Takeaways
- There’s a lot of debate over the role of fertility testing, with some experts calling the information a useful baseline and others arguing that it’s expensive, invasive and not particularly useful.
- For men, fertility testing is relatively straightforward. For women, it quickly becomes more invasive and time consuming.
- While the results of a single test aren’t a great prediction of a future pregnancy, taken in context with your medical history and physical exams, fertility testing may help paint a more comprehensive picture of your fertility health. That can help inform next steps.
The Pros & Cons of Fertility Testing
Experts debate the merits of fertility testing for one very good reason. While tests can offer baseline information, they can’t accurately predict whether or not a conception will occur. That’s why some experts argue that fertility testing can be anxiety provoking and actually offers little actionable insight. Proponents of fertility testing say that there are benefits to learning about your fertility before you start trying for kids because it makes you feel informed and better prepared to make decisions that can move the needle one way or the other. Here at Beli, we’re in the more-information-is-better camp, but we firmly believe that this sort of thing is a personal decision.
Fertility Testing for Men
For men, fertility testing is fairly straightforward and involves a sperm sample and sometimes a blood sample to evaluate hormone levels, especially testosterone. While men don’t generally have a reproductive expert on call, like women do with the gynecologist, there are fertility specialists everywhere, and even at-home sperm testing and hormone test kits, which can be illuminating. Considering the fact that external factors like nutrition, stress management, fitness and lifestyle choices (everything from alcohol use to CBD to caffeine, even hair loss treatments) can have a direct effect on sperm health, sperm testing can be a simple way to get baseline information.
Quick reminder that sperm quality is measured in a few ways:
- Sperm quantity describes the count and concentration of sperm in semen, and this is a parameter you can check with an at-home sperm test kit.
- Sperm morphology is the shape and the size of the sperm. Abnormal sperm are associated with lower fertility rates.
- Sperm motility is how well sperm move, which is a key component of a successful conception. Some at-home tests check for motility.
- Degree of DNA fragmentation. Damage to the DNA in sperm isn’t uncommon, but the more widespread the damage, the greater the association with infertility and miscarriage. A fertility specialist can conduct several tests to determine sperm DNA integrity.
Sperm health can vary significantly over just a few weeks, so what you do today has an impact—for better or for worse—on your sperm. Men produce millions of sperm every day, but every single one of them takes about three months to fully mature in preparation for potentially fertilizing an egg. This preconception window is a prime opportunity for men to support their fertility health (and we have 11 easy tips to do just that). And it matters. A preconception health series published in the Lancet Journals emphasizes the pivotal role of health and nutrition in hopeful parents. Researchers called it “important not only for pregnancy outcomes but also for the lifelong health of their children and even the next generation”(2).
Fertility Testing for Women
A year can feel like a long time to spin your wheels if you’re concerned about a deeper issue relating to fertility. If your gynecologist doesn’t show the necessary amount of concern, find a fertility specialist who’s willing to run some tests. Fair warning: for women, thing get a little more complicated and certainly more invasive pretty darn fast, ramping up from lots of blood work at different times in your cycle and homework like basal body temperature charting to ultrasounds and tests like hysterosalpingogram, hysteroscopy, laparoscopy and endometrial biopsy. For couples jumping through all these hoops, about 85% will be rewarded with some idea as to why they’re having trouble getting pregnant, according to WebMD (3).
For women, blood tests are generally step one. These are designed to measure either antimüllerian hormone (AMH) or follicle-stimulating hormone (FSH) to assess how many eggs are in a woman’s ovaries. At-home hormone tests are also designed to provide this level of information. However, research shows that ovarian reserve testing just isn’t a reliable predictor of future pregnancies (4). In fact, according to the American Society for Reproductive Medicine, “markers of ovarian reserve have been shown to be good predictors of oocyte yield, but poor independent predictors of reproductive potential. Therefore, they should not be used as a fertility test or to deny access to infertility treatment ”(5).
Another thing to keep in mind—for women, fertility testing can be expensive and time consuming, and insurance coverage is iffy at best, depending on where you live, what kind of plan you have, and whether or not the tests and procedures qualify as being “medically necessary.”
Our Take
It’s true that a single result doesn’t define someone’s fertility. But the information it provides, taken in context with details like your full medical history, physical exams and perhaps an ovulation test, can provide a more comprehensive picture of your fertility at this moment. That kind of holistic view gives you a starting point for embracing actionable change to support your fertility health. What’s more, this kind of testing can also reveal health conditions that can directly affect fertility, like endometriosis or PCOS.
In many instances, our fertility health is reflected in our overall health. That’s why taking steps to improve our general health has a positive impact on fertility health. For couples hoping to conceive, a healthy lifestyle plays an enormous role. In addition to generally cleaning up their lifestyle to improve their general health, experts also recommend starting prenatal vitamins sooner rather than later. For women, a prenatal vitamin covers nutritional gaps and ensures a steady stream of all the right nutrients, especially choline and folate, in the event you conceive earlier than you thought. So much critical development happens in the very earliest weeks, often before a positive pregnancy test, so starting prenatal vitamins early is key.
For men, prenatal vitamins are equally important. Research shows that the most common cause of a sperm deficiency is a lack of specific nutrients and other lifestyle factors (6). A prenatal vitamin like Beli Vitality™ for Men is formulated with vitamins, minerals and antioxidants to support his fertility health.
Ultimately, fertility testing is a personal decision. If you decide it’s information you want to have, your best bet is to find a reproductive specialist who can discuss your options and help you interpret results.
Article Resources
1. How common is infertility? (2018). https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/common
2. Preconception Health. The Lancet. (2018). https://www.thelancet.com/series/preconception-health
3. Fertility tests for women. https://www.webmd.com/baby/features/fertility-tests-women
4. Harris, B et al. (2023). Markers of ovarian reserve as predictors of future fertility. https://www.sciencedirect.com/science/article/pii/S0015028222019641
5. Testing and interpreting measures of ovarian reserve: a committee opinion (2020). American Society for Reproductive Medicine. https://www.asrm.org/practice-guidance/practice-committee-documents/testing-and-interpreting-measures-of-ovarian-reserve-a-committee-opinion-2020
6. Skoracka, K et al. (2020). Diet and nutritional factors in male (in)fertility—underestimated factors. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7291266/
