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Having trouble getting pregnant? These fertility tests may give you the answer
When a couple or a woman decides to take the first step towards motherhood, questions such as: What types of fertility tests exist, what is the cost of these fertility tests, age limit for fertility treatmen in Spain? or how do I know if I am fertile? At Vida Fertility, we know that these doubts can be overwhelming, so we talked to the medical director of Vida Fertility Alicante, Dr. Alejandra García Villalba, about the diagnostic fertility tests you need to identify the cause of why you are not getting pregnant.
- 1. Fertility tests: what are they?
- 2. Basic fertility tests done during your first visit
- 3. Advanced fertility tests for complex cases
- 4. Fertility tests for single mothers
- 5. FAQs on fertility tests
- 5.1. When should I see a fertility specialist?
- 5.2. When should I run these fertility tests?
- 5.3. Are these tests necessary before starting assisted reproduction treatment?
- 5.4. Is fasting or prior preparation required for fertility tests?
- 5.5. Do fertility tests detect all causes of infertility?
- 5.6. When do I receive the results of my fertility tests?
- 5.7. How do I know if I am sterile or not?
- 5.8. What is the test for genetic compatibility?
- 5.9. What do they do at a first IVF consultation?
- 5.10. Ask for a consultation
- 5.11. Testimonials
Fertility tests: what are they?
Fertility tests are the first step in understanding what lies behind the difficulty in achieving pregnancy. These tests seek to analyse the reproductive capacity of the couple or the woman who wants to get pregnant, providing key information to determine the most appropriate fertility treatment.
At Vida Fertility, we understand that each fertility case is unique. Therefore, we have a wide variety of diagnostic tests to offer a complete and personalised analysis.
Below, we detail the basic fertility tests that are performed on a first visit and advanced fertility tests for more complex cases.
Basic fertility tests done during your first visit
Fertility tests with your partner
If after a year of unprotected sexual intercourse, you haven’t achieved a pregnancy, you may have an infertility. For this reason, it is important that both the man and the woman undergo the necessary fertility tests.
According to Dr García-Villalba, “These tests allow us to identify the underlying causes of infertility and propose the most appropriate treatments”.
Complete blood test
For women, it includes studies such as haemogram, biochemical profile, serology (HIV, Hepatitis, Syphilis, among others), basal hormones such as LH, FSH, Progesterone, Oestradiol, specific ones such as Anti-Müllerian Hormone (AMH) to evaluate your ovarian reserve.
For men, blood test includes serology and, depending on the patient’s case, other tests like hormone profile (LH, FSH, testosterone).
Sperm analysis
Sperm analysis, also known as spermiogram or spermogram, is a test designed to determine the quality of the sperm.
This procedure evaluates both macroscopic characteristics, such as the volume and pH of the seminal fluid, and microscopic aspects, including sperm concentration, motility and shape.
Gynaecological exam
We perform a transvaginal ultrasound, where we will count the antral follicles (which helps us to know the ovarian reserve) and assess whether there is any ovarian pathology (cysts, teratomas, endometriomas…), tubal pathology (hydrosalpinx, adherencias, cysts) or uterine pathologies (myomas, endometrial polyps, adenomyosis…).
In addition, we will perform a vulvar and vaginal exploration to check for any problems such as vaginal septum. With the placement of the speculum, the cervix can be examined to see if there is any morphological alteration at this level, such as a closed external cervical orifice or two cervixes per didelphic uterus. In addition, a cytology should be performed as a screening for cervical cancer.
On the other hand, a vaginal examination will be performed to help us in this exploration. For example, endometriotic nodules may be palpated in the rectovaginal septum, or if cervical mobilisation is painful, it could indicate pelvic inflammatory disease.
Perform a breast and axillary examination, from the age of 40 onwards, to assess the possibility of palpation of nodules or cysts that may be hormone-sensitive.
Advanced fertility tests for complex cases
Female fertility tests
We evaluate levels of vitamin D, TSH, anti-thyroid antibodies (Anti-TG, Anti-TPO) and other hormonal markers essential for reproductive success (prolactin, testosterone, DHEA etc).
We also carry out a thrombophilia study to identify whether a person has a genetic or acquired predisposition to develop blood clots (thrombosis) or in cases of repeated miscarriage, etc.
Examins
In addition to those mentioned above, the fertility specialists at Vida Fertility can perform the following tests to determine the state of the tubes, uterus and endometrium: –Hysterosalpingosonography or hysterosalpingography: to assess by introducing contrast into the uterine cavity whether it passes through the tubes and to determine whether there is pathology due to obstruction, morphological alteration, etc. In addition, alterations in the uterine cavity can be assessed.
- 3D ECO: allows detection of uterine morphological alterations such as septate uterus, bicornuate uterus, etc.
- Diagnostic hysteroscopy: to determine the morphology of the cavity as well as to diagnose and resolve possible pathologies such as endometrial polyps or uterine fibroids.
- Endometrial biopsy: pathological anatomy, cd138 (endometritis marker), as well as culture or endometrial microbiota, endometrial receptivity window or immunology can be studied.
Chromosome and genetic studies
At Vida Fertility we have the most advanced tests to diagnose and treat the most complex cases of infertility.
- Chromosomal studies: These tests include karyotyping of the couple, essential to identify chromosomal alterations that may be affecting fertility or embryonic development.
- Genetic studies: If patients wish to reduce genetic risks or have a history of hereditary diseases in the family, a test for recessive genetic diseases can be performed.This analysis can detect whether both members of the couple are carriers of the same genetic disease, which could increase the risk of transmitting it to the future baby. To avoid this risk, the results of both partners are matched.
- Embryo testing: If any of the above tests reveal alterations or if there is a medical recommendation (such as in cases of advanced maternal age), advanced genetic studies can be performed on embryos, such as PGT-A or PGT-SR (to analyse chromosomal alterations) and PGT-M (to detect monogenic diseases).
- Cases of implantation failure or repeated miscarriages: In these situations, more specific tests can be performed such as the KIR-HLA study, which analyses
the immunological compatibility between mother and embryo, a key factor in achieving a viable pregnancy.
With these tools, our team of assisted reproduction specialists can customise your treatment to maximise the chances of success in each case.
Specific tests for male fertility
A male fertility study begins with an advanced sperm analysis, which is the primary test to assess semen quality.
In addition, depending on the results and the patient’s medical history, additional male fertility tests such as sperm DNA frangmentation, Fish sperm techniques, sperm apoptosis may be performed.
If any of the tests are abnormal, laboratory techniques such as microfluidic sperm selection, PICSI, MACS etc. can be used. If required, a testicular biopsy can be performed.
Learn more about fertility check-up
Fertility tests for single mothers
If you are a single woman looking to fulfil your dream of becoming a mother, at Vida Fertility we have designed a protocol specifically for you. Our medical team performs comprehensive testing to ensure you have all the information and options you need.
These exams will depend on the patient’s history, whether she has had any previous treatment and her age to identify which treatment is ideal to achieve pregnancy. The tests required for a single mother are:
Basic fertility tests for single mothers
Before starting any assisted reproduction treatment in Europe, a series of basic tests are carried out to assess the patient’s reproductive health:
- Complete blood test: Includes serology and key hormone profiles to assess general and reproductive health status.
- Gynaecological examination: A detailed examination including transvaginal ultrasound, vulvar assessment, vaginal examination and breast examination.
- Ovarian reserve: This test is key to determine the quantity and quality of eggs available, assessed by anti-Müllerian hormone (AMH) and an antral follicle count.
Advanced testing for complex cases
In some cases, it may be necessary to further diagnose with more advanced tests. These can identify possible barriers to pregnancy:
- Comprehensive hormone assessment: including vitamin D, TSH (thyroid hormone), prolactin and testosterone levels, essential for balancing hormone health.
Thrombophilia studies: tests for clotting disorders that could influence the achievement of the pregnancy. - Advanced gynaecological examination: 3D ultrasound, hysterosalpingography (to assess tubal patency) and, if necessary, endometrial biopsy.
- Karyotype: A genetic study that identifies possible chromosomal alterations, especially useful for preventing complications.
At Vida Fertility we understand that infertility can have both female and male causes, or even a combination of both. This is why it is essential to have a complete fertility work-up both partners in cases of shared parenthood. For women who opt for single motherhood, we adapt the necessary tests to their specific situation.
FAQs on fertility tests
When should I see a fertility specialist?
Dr. Alejandra García-Villalba answers: As a general rule, it is recommended to go to a fertility specialist after one year of unsuccessful pregnancy search, if you are under 35 years old. If you are over 35, it is advisable to seek help after six months. In cases of specific medical history, such as irregular menstrual cycle, previous miscarriages, endometriosis or known fertility problems, prior consultation is recommended.
At Vida Fertility, we are ready to guide you at the right time.
When should I run these fertility tests?
Dr. Alejandra García-Villalba answers:
Fertility testing is recommended if you have been trying to conceive for some time without success.
In women, they can be performed at any time during the menstrual cycle, although some specific tests, such as hormone screening, must be done on certain days of the cycle. For men, sperm analysis can be done at any time.
Are these tests necessary before starting assisted reproduction treatment?
Dr. Alejandra García-Villalba responds:
Yes, the basics are essential. Fertility tests allow us to understand the cause of infertility and personalise treatment.
For example, knowing your ovarian reserve, semen quality or possible uterine problems will help us decide whether a treatment such as artificial insemination, IVF or egg donation is the best option for you.
Is fasting or prior preparation required for fertility tests?
Dr. Alejandra García-Villalba answers:
Most fertility tests do not require fasting. However, for more specific tests such as prolactin or homocysteine, fasting may be required. For men, the seminogram requires sexual abstinence for 2 to 3 days before collecting the sample.
Do fertility tests detect all causes of infertility?
Dr. Alejandra García-Villalba answers:
Although fertility tests are very comprehensive, they do not always detect all causes of infertility. Some may be more complex or multifactorial, such as certain immunological or genetic problems.
In fact, there are approximately 20% of the causes of infertility of unknown origin.
For this reason, at Vida Fertility we have advanced technology and a multidisciplinary team that allows us to deal with even the most complex cases.
When do I receive the results of my fertility tests?
Dr. Alejandra García-Villalba replies:
The time depends on the test. For example, the results of a semen analysis can be available in a few hours, while hormone tests usually take between 24 and 48 hours.
More complex tests, such as genetic studies or karyotype, can take several weeks. At Vida Fertility, we make sure to streamline the process so you get your results as soon as possible and can make informed decisions quickly.
How do I know if I am sterile or not?
Through the study of basic tests (amh, basal hormones, seminogram, basal ultrasound, urological examination), as well as medical assessment. You can read more information on how to know if you are fertile in this article.
What is the test for genetic compatibility?
When a couple decides to start a family, one of the most important aspects is to ensure that the baby is born healthy, avoiding the transmission of genetic mutations that could have been identified through a previous genetic compatibility test. The road to safe parenthood can be paved by the Carrier Genetic Test (CGT), also known as carrier genetic testing.
Even if prospective parents have no symptoms of any disease, most people carry at least one genetic mutation that could cause serious conditions in their children. If both parents carry mutations in the same gene, there is a 25% chance that the baby will inherit the disease.
With CGT, it is possible to perform a thorough genetic evaluation to identify potential risks and, if necessary, opt for solutions such as testing embryos for that mutation or gamete donation to ensure as far as possible a safe pregnancy and a healthy baby
What do they do at a first IVF consultation?
At your first IVF consultation at Vida Fertility, we conduct a series of in-depth assessments to better understand your needs and how we can effectively help you. Here are the common tests you can expect during your first visit:
Ask for a consultation
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ℹ️ The information published on Vida Fertility is reviewed by our fertility specialists and medical team, following up-to-date scientific criteria and evidence-based medicine. Our team is a member at scientific societies such as SEF, ESHRE and SEGO.
