What is a fertility check?
- A fertility check is an assessment, performed via blood test and ultrasound, to predict a woman’s current fertility and her likelihood of conceiving later in life.
- The fertility check is recommended for younger women who are not ready to have a child but want to know if they should consider egg freezing for a later pregnancy.
- Anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH) and estradiol are measured to predict a woman’s ovarian reserve, which is the potential number of eggs a woman has left to release from her ovaries.
- A fertility check is ideal for women 22-46 years of age who have a regular menstrual cycle.
Why a fertility check is beneficial
Loma Linda University Center for Fertility & IVF offers a fertility check to help women make an informed decision about when to have children. Egg freezing technology can improve women’s chances of a successful pregnancy later in life, if they choose to wait to start a family after their optimal years of fertility have passed.
Age directly impacts fertility by decreasing the quantity and quality of eggs a woman produces in her lifetime. For example, by the time a woman is in her late 30s, it is likely that her chance of conceiving has dropped to approximately 10 percent per month, half of what it would have been in her mid 30s.
Some women have a lower number of eggs than predicted for their age, however and a fertility check can determine if this is the case.
A fertility check can help a woman know how fertile she currently may be and what her chances of pregnancy could be in the future if she waits to conceive. For younger women who would like to wait for pregnancy, the fertility check can help determine whether or not they should consider freezing their eggs for later use.
Advances in reproductive technology have greatly improved the outcomes of flash freezing (vitrification) of a woman’s eggs, resulting in an increase in the number of women (particularly young women) choosing this form of fertility preservation.
The egg freezing process takes about 4-6 weeks and includes hormone injections to stimulate ovulation, egg retrieval and cryopreserving the eggs, which involves freezing and storage.
What does a fertility check include?
The fertility check is simple and includes the following elements.
With one blood draw, done on day 2 or 3 of the menstrual cycle, we will check hormone levels of AMH, estradiol and FSH.
- Anti-Müllerian hormone is released by follicles in the ovaries, where a woman’s eggs mature. Therefore, AMH levels correspond to the number of follicles, which indicate the quantity of eggs in the ovaries. Low levels of AMH could indicate poor ovarian reserve. High levels of AMH may suggest the presence of polycystic ovary syndrome (PCOS), which is often associated with hormone imbalances and sometimes infertility.
- Follicle-stimulating hormone is produced by the pituitary gland to aid in the development of follicles in the ovary. FSH levels can vary from month to month. If levels are normal, the follicles should be promoting viable egg production. If FSH levels are abnormal, the woman’s egg quality may be diminished.
- Estradiol is one of the most important hormones in reproduction. Estradiol is responsible for reproductive organ growth in women and is essential for proper development of the vagina, endometrium, fallopian tubes, cervical glands and the muscle layer of the womb. It also initiates events that lead to ovulation and the maintenance of eggs in the ovaries.
Follow up for results
Our physicians will review the outcome of the fertility check with you approximately 1-2 weeks after the checkup to clarify results and answer questions.
Who should check their fertility?
Women between the ages of 22-46 who have a regular menstrual cycle (every 20-40 days) are ideal candidates for the fertility check. Women who would like to wait to try and conceive may opt to check their fertility to determine whether they should pursue egg freezing.
How often should a fertility check be performed?
Frequency of the fertility test will depend on the woman’s age and her prior test results. Generally, the suggested interval for the fertility check ranges from every two years for younger women with favorable results to every six months for women with poor results. Our physicians can provide more specific guidance for individual cases.
Can you do a fertility check while using contraception?
Hormone analysis, factored with a woman’s age, is the best way to predict a woman’s ovarian reserve. Contraceptive medications can interfere with the test and may need to be discontinued for accurate results. Typically, a woman on oral contraceptives (birth control pills) will get a regular period and should have her blood drawn on the second or third day of bleeding.
If a woman uses a contraceptive ring or patch, she should discontinue the medicine for five days before having blood drawn. If a woman is using an intrauterine device, she must have the device removed and wait for three regular menstrual cycles before the fertility check can be performed.