The causes of infertility are many and varied and can involve the male or female partner or a combination of both. For the female blood tests and ultrasound scans can help your fertility specialist identify any issues and ensure you’re ovulating normally. Please note that not all the below tests are included in the Couples Fertility tests, click here to see which tests are included.
Female fertility investigations may include:
- Ovulation test
A simple blood test to determine if you are ovulating normally.
- Ultrasound scan
To check the lining of the uterus for the presence of fibroids or polyps which may impair conception. An ultrasound can also show the size of the ovary, size and number of follicles and the presence or absence of ovarian cysts.
- Anti-Müllerian Hormone (AMH or “egg count”)
AMH is produced only in small ovarian follicles and blood levels have been used to attempt to measure the size of the pool of growing follicles in women. Research shows that the size of this pool of growing follicles is heavily influenced by the size of the pool of microscopic follicles you developed as a baby. Therefore, AMH blood levels are thought to reflect the size of the remaining egg supply - or “ovarian reserve”.
With increasing age the size of the pool of remaining microscopic follicles decreases. Likewise, blood AMH levels and the number of ovarian follicles visible on ultrasound also decreases. Women with many small follicles, (such as those with polycystic ovaries) have high AMH hormone values while women that have very few remaining follicles and those that are close to menopause have low anti-mullerian hormone levels.
It should be remembered that measuring AMH alone cannot predict whether a woman is able to become pregnant – there are other important factors that have to be taken into account including lifestyle, past medical history, anatomic and genetic abnormalities, quality of sperm and other male factors - but it is still considered the best hormone to help identify your potential long term fertility.
- Thyroid Stimulating Hormone (TSH)
Thyroid hormones are essential and primary regulators of the body’s metabolism and imbalances can affect virtually every metabolic process in the body, including significant effects on mood and energy levels. Thyroid function has a profound impact on overall health via:
- Modulation of carbohydrate, protein and fat metabolism
- Vitamin utilisation
- Mitochondrial function
- Digestive process
- Muscle and nerve activity
- Blood flow
- Oxygen utilisation
- Hormone secretion
- Sexual and reproductive health
- Many other physiological parameters
These imbalances may elicit fatigue, depression, coldness, constipation, poor skin, headaches, PMS, dysmenorrhea, fluid retention, weight gain, anxiety/panic attacks, decreased memory and concentration, muscle and joint pain, and low sex drive. The TSH test is the test of choice for evaluating thyroid function and/or symptoms of hyperthyroidism (overactive) or hypothyroidism (underactive).
Prolactin is a hormone produced in the pituitary gland. An imbalance can impact of fertility.
- Saline infusion sonohysterography (SIS)
A relatively non-invasive test, comprising of an ultrasound after inserting a tiny tube into the cervix to pass saline through the uterine cavity and fallopian tubes.
When to seek help?
If you have been trying to conceive for more than 12 months (or 6 months if you are over 35 years of age) without success, we recommend you book an appointment with a fertility specialist who can conduct some simple fertility tests.