When Should Couples be Investigated for Infertility?

Posted by Cecil Horwitz



With an estimated 1 in 6 Canadian couples struggling with fertility challenges, further investigation into ‘why’ is becoming more important. You may find yourself wondering when is the right time to begin further investigating your fertility health, and the answer is generally the sooner the better.

If you have any suspected reason for infertility (such as absence of menstrual periods, sperm issues, prior treatment of cancer, PCO’s, thyroid issues, anatomical abnormalities, etc.) or if you are a women over the age of 35yrs then you should push for referral for investigation as early as possible. If there are no suspected indications of infertility, investigation should occur after difficulty conceiving after 1yr of regular unprotected sex.

Subfertility is the condition of being less than normally fertile, though still capable of fertility – meaning that through identifying the affecting factor you can potentially modify and enhance your fertility health. Investigation helps us identify the underlying cause of fertility difficulties, which gives us power to do something about it!

Infertility Investigations
Approximately 1/3 of infertility is attributed to female factors, 1/3 to male factors, and 1/3 to unexplained or combination factors. That said, it is extremely important to consider examination of both partners when investigating a couple.

Basic Investigations
Basic investigations are typically performed by your GP and include examination of both partners. Fertility investigations take into consideration the eggs, sperm, fallopian tubes, and the uterus. Hormonal tests, such as FSH and LH, as well as progesterone, thyroid, and prolactin level tests may be performed in women. Women may also receive a cervical smear, STI testing, and may be checked for rubella antibodies. In men, semen analysis is typically performed (and absolutely should be in every case).

Secondary Care Investigations
Secondary Care Investigations are typically performed by gynecologists and/or reproductive health specialists. Ultrasounds, laparoscopy, and HSG or HyCoSy may be used to examine tubes and ovaries and check for pelvic diseases in women. Sperm examination, endocrine tests, testicular biopsy, or scans of urogenital tract may occur for men.

Advanced Tests
Advanced tests are typically performed by fertility clinics. These investigations may include examinations such as the AMH (advanced female hormonal) test, Antral Follicle Count scan, advanced semen parameters test, and hysteroscopy.

It is important to be an advocate for your own health and well-being, and push for what you feel you need. The sooner you take charge of your own health, the sooner you will feel the benefits.
Further, acupuncture and Chinese medicine can do a lot to enhance your fertility and reproductive health – and does so naturally! Learn more about fertility health, or contact us to schedule an appointment to talk to one of our practitioners about how to enhance your fertility and overall well-being!