Yeah, it’s not that easy!
For some, it’s the first try. For most, it’s a gruelling 6/12+++ month process of silence, unanswered questions, and quite frankly, a bloody mind fu*k!
First things first, there are some tests you can get out of the way if you’d like to deep dive into your current fertility situation. Your GP will most likely get you to some standard blood tests before trying to conceive.
Now there are quite a few tests, if this is not your thing, hold off and just give it a good ol’ nudge. Head on over to our Deep Dive page to explore some common methods.
In Australia, we also have a Pre-IVF Fertility Testing Rebate. This is a $500 rebate from medicare to cover the costs of some of the tests mentioned below. This is a great new initiative from the Australian Government allowing infertility knowledge and assistance to be accessible to all. Whilst we are talking IVF, if you are considering this path (including egg freezing), there are obviously private health care providers that can assist like Genea, IVF Australia, and Monash, who are extremely expensive, but there is also now a public route. This is a lot more cost-effective and yields the same outcomes, the only catch is there is a longer wait time. If time is on your side though, you’re in luck! Read up on that here.
There is also a new NSW rebate under the Albo Ministry! Check that out here
AND… Melbournites, in some cases, can access free IVF! Check that out here
Investigations and tests for women:
Standard blood tests
Prolactin (PRL). This hormone is normally elevated during pregnancy as it plays an important role in the preparation and establishment of breastfeeding. It may be raised in women who are not pregnant but whose periods have ceased or become very infrequent.
Thyrotrophin (TSH). The level of this hormone should be checked to see if the thyroid gland is under-active, which be linked to irregular periods.
Androgens. Women with ovulation problems or who have polycystic ovarian syndrome (PCOS) may have elevated androgen levels.
Baseline pelvic ultrasound (in the early follicular stage of your cycle)
Ultrasounds are a great way to check for things like ovarian cysts (PCOS), fibroids, and polyps which can all affect your cycle. Ideally, get your vaginal scan organised by an imaging service specialised in women’s health. This should give you a good indication of your follicle growth per cycle. In Australia, this scan can cost around $250 - $450 depending on where you go with a Medicare rebate.
Further blood tests: Day 2-5 FSH, LH, PRL, TSH
Blood tests can help to determine if your hormone levels are in the right range or may be causing some ovulation concerns. These blood tests need to be completed in the first week of your period. The test to see whether ovulation has occurred happens in the second half of your cycle, about a week or so before your next period.
AMH aka 'Egg timer' test
Another blood test can measure your ovarian reserve. Known as the “egg timer” test, this blood test measures Anti-Mullerian Hormone (AMH) and gives an indication of your fertility and egg reserve. AMH paired with the above-mentioned ultrasound is a great indicator of where you sit in regard to egg reserve. Please note that being on the pill, or any fertility hormonal replacements, may impact the results as well as shift work. This test isn’t covered by Medicare (unless within the fertility testing rebate) and costs ~$80.
This is also just an indicator. It is not THE number of eggs you have left.
Screening for infectious diseases and immunity
Includes screening for HIV, Hepatitis B, Hepatitis C, Rubella and Varicella.
Investigations and tests for men
Semen analysis and antibody test
A semen analysis allows doctors to assess the quantity and quality of sperm. This test provides information regarding the motility (movement), morphology (shape), count and vitality of sperm. This involves the male ejaculating into a specimen cup and dropping it off at a testing lab within 2 hours.
We have a link to a World Health Organisation semen study if you’re interested.