Exploring the Importance of Fertility Tests for Both Women and Men
Fertility testing is growing in popularity as couples are delaying family building and are concerned about their reproductive health. Social fertility has become more mainstream, thanks to technological advancements in fertility treatments, popular culture trends of preserving and delaying fertility, and a growing maternal age at first birth. Testing for fertility can provide valuable information to determine if there are underlying issues that need to be treated to achieve a pregnancy. Females are born with their total egg supply, which is particularly distressing as egg supply and egg quality decline exponentially after peaking in the mid-twenties. Unfortunately, infertility can affect both women and men.
The societal implications of not being able to have a biological child of one’s own can be distressing for individuals and couples and lead to increased stress, anxiety, and depression, which can also have long-lasting emotional effects. This is why it is extremely important for individuals to see a fertility consultant if there are any questions about their reproductive health or if they have been trying to conceive for six months if they are over the age of thirty-five or have been making efforts to get pregnant for twelve months if they are thirty-five years of age or younger. Part of fertility education and awareness has to do with knowing when to get testing and also understanding what those initial tests will indicate. This will also explore basic information and symptoms to look out for each sex when it comes to fertility and which tests to utilize to identify reproductive pathologies.
1. Understanding Female Fertility
Understanding female fertility is a complex process the human body undergoes in order to conceive a child. Female fertility starts with the release of a mature egg from a woman’s ovary known as ovulation and ends with the egg being fertilized. The quantity and quality of the eggs that a female has and the quality of the sperm a male has are important factors in conceiving. The amount of ovulation that happens in a woman’s lifecycle is staggering; she will ovulate 400 times before she reaches the age of 40. Many changes occur in the human body for a successful pregnancy. The following factors will determine a woman’s fertility: • The frequency and regularity of ovulation. • The quality of the woman’s eggs. • The health and function of the woman’s reproductive organs. • A balanced hormone regime, functional levels of both FSH and LH hormones. • A balanced nervous system. Female infertility can be attributed to either one of these vital body performances or the effect of a combination of multiple factors. Female age and fertility Prior to offering any fertility treatments or conducting tests determining female fertility, gynecologists recommend that female patients understand the influences of age on fertility. There are currently no techniques to preserve the present function or state of any systems that deteriorate due to aging. Before any tests are done to determine female fertility, many doctors recommend making either lifestyle changes to improve body functions or looking at the infertility problem holistically. Roughly 1 in 8 women face problems with fertility. The stress surrounding trying to conceive a child can be immense, adding an extra layer of psychological burden on them. Every childbearing woman is born with a special reserve of eggs. Each menstrual cycle, a woman ovulates an egg out of the reserve she was born with. The simple process of childbearing uses nearly 100 eggs.
1.1. Common Female Fertility Tests
Often, a gynecologist determines which test is best suited for a patient as well as which ones are most likely to result in a successful pregnancy. Common female fertility tests and the purpose of each include:
– Blood tests – Blood tests are used to measure hormone levels and diagnose different hormonal systems. They can be used to diagnose whether the ovaries are not functioning normally or if the brain is not communicating with the ovaries. The main reproductive hormones tested in women are follicle-stimulating hormone, luteinizing hormone, estradiol, anti-Müllerian hormone, and thyroid function tests to check that the thyroid is working normally. Prostaglandins tests can show how many eggs are available to a woman’s reproductive life.
– Estradiol Hormone – is used throughout the cycle just like follicle-stimulating hormone, luteinizing hormone, and progesterone, except for anti-Müllerian hormone. If estradiol levels are elevated on day 3, this may be suggestive of poor ovarian reserve. An abnormal result indicates that further investigation is needed and the chances of becoming pregnant may be decreased.
– Ultrasound – An ultrasound examination of the reproductive organs. The main purpose of ultrasound in fertility testing is to identify ovarian follicles or cysts, as well as the presence or size of endometrial cysts. It can also be useful in the diagnosis of uterine and tubal diseases.
– Hysterosalpingography – An HSG is a radiographic test used to examine the uterus and fallopian tubes. It can be a valuable test because it shows whether whether the tubes are unobstructed or blocked. Blocked tubes are common but simple to treat with surgery or IVF. Using a dye to outline the tubes, it may also be useful to look at the cavity of the womb and diagnose any polyps or fibroids.
– Endometrial biopsy – is a test to check the uterine lining for any signs of abnormality or inflammation. A biopsy is not usually performed to test for infertility, but if abnormal inflammation or fibrosis is present, it may be more difficult for an embryo to implant. The earlier a problem is identified in the process of understanding female fertility, the sooner it can be addressed. Knowing preventative options and the tools available to help progress a couple’s journey towards starting a family is empowering. With a variety of other causes and lifestyle influences known to affect female fertility, this sub-section provides helpful insight.
2.1. Factors Affecting Female Fertility
Female fertility in women can be affected by a variety of factors. Age is the most important ones. As age advances, the number of eggs in the ovaries and the quality of the remaining eggs reduce. Therefore, in cases where female age is advanced, the possibility of pregnancy in other conventional treatment methods decreases and the need for egg donation increases. Lifestyle has a big impact on female and male fertility. Lack of physical activity and inadequate nutrition can have negative effects on reproductive health. Again, regular exercise and a diet rich in vitamins, minerals, and antioxidants contribute to fertility rates. Smoking, alcohol, and drug use particularly decrease reproductive hormone levels in women and adversely affect ovarian reserve. Weight affects fertility negatively in men and women as well. Especially, obesity disrupts hormonal balance, the menstrual cycle, and ovulation in women’s bodies. Sexual desire and satisfaction decrease. A blockage in hormone release leads to irregularities and menstrual cycle disorders. This affects ovulation and can lead to infertility. Ovulation may cause menstrual periods in women. Polycystic ovary syndrome is a frequently occurring condition.endocrine system condition among women of reproductive age.
A large number of menstrual cramps, excessive hair growth, minimal menstrual periods, and an unusual growth in the clitoris may all be symptoms. The first step for prospective mothers and their partners is to undergo some tests for the presence of any reproductive health problems. The results of the tests affect the planning of the process. This is very important when we think about the treatment options that can be shaped according to the need. The test results will show women what to do to protect their reproductive health. Examinations can offer important insights and reassurance about the reproductive system. Thus, some troubling stories and experiences in society can be prevented. It is very important to make women’s health visible and to seek solutions together. In the light of this information, women can make the best decisions for their bodies. Because female fertility is a very complex issue, and influences seem to depend on each other. No one knows everything. However, It is believed to be useful for women to be aware of the factors affecting fertility.
2. Understanding Male Fertility
In a world where women’s fertility is often the focus, it can be easy to overlook the intricacies of male fertility. Reproductive health is a multi-faceted phenomenon, and male fertility actually plays a crucial role in overall reproductive health too. Sperm are produced in the testicles through a process called spermatogenesis, and sperm quality and quantity are key in reproduction. Fortunately, the production of high sperm numbers means that, in general, men’s fertility tends to be more protected and less impacted by age. As men age, they gradually experience a decline in fertility, sperm quality, and quantity, in addition to an increased risk of sperm DNA fragmentation. It can be very helpful for men and women to understand this; often, we see women or couples who expect the woman might be experiencing fertility issues, only for the man to discover otherwise. As in women, simply having regular unprotected sex is the key to increasing the chances of getting pregnant.
Understanding the complexities of male fertility can allow us to alleviate some of the stress about fertility timelines that couples are facing or diving into detailed medical testing, treatments, and procedures. A better understanding of the male fertility process can also end the misconception that infertility is primarily a female issue and can help to normalize and humanize the feelings that men experience when they discover they might be experiencing fertility challenges. Receiving an abnormal semen analysis result, such as low sperm count or poor sperm motility, can be distressing for men, even depressing for some. Men’s psychology is still not well studied, but theories suggest that fertility problems can feel emasculating for certain men. Because of the deep intimacy with our romantic interests and our fertility, it can be very trying for men when infertility affects their relationships. A yet little explored path is conducted by therapists who are trained on the links between sexuality and fertility. Both men and women can be provided with a better understanding of their fertility process, as well as some tools and coping strategies
2.1. Frequently Performed Male Fertility Tests
Male semen analyses are the most common fertility assessments carried out for men. Through such tests, detailed assessments can be made concerning a patient’s sperm motility or count and the shape of the sperm; samples are typically collected via masturbation and liquid nitrogen-frozen for fertility preservation. Given the above, semen analyses are not often carried out more than once, as unless there have been significant lifestyle changes, the results are generally proven to be replicable. The patient will usually need to abstain from ejaculation for a period of at least 2–7 days prior to the sample being collected, while some clinics may also present dietary and lifestyle guidelines to the patient. Sub-fertile single men additionally will need to know that lifestyle factors will signal about additional genetic tests, given that even the sub-fertile state has been proven to pass on the genetic trait to the next generation.
Hormonal assessments can also be carried out to gauge the levels of reproductive hormones, such as FSH, LH, and testosterone. Similar to tests for women, such tests are usually taken on day 3, immediately when testosterone levels peak in the male. Genetic tests should also be administered to offer a patient a comprehensive overview of their reproductive health. Although few genetic tests are commonly prescribed to men, those that are offered—and thus tested for—include the chromosomal karyotype, Cystic Fibrosis Screening, Y chromosome microdeletion tests to understand the presence and probable cause of non-obstructive azoospermia, if applicable, and single mutations detectable via pre-implantation diagnostics. Treatments available for men with fertility issues may be drastically altered depending on the presence of single mutations or a genetic disease background in the family.
Male Infertility
Appropriate tests can provide a good indication as to the extent Related to male fertility issue and improve the chances of successful treatments. In the case of a true ‘male infertility’ diagnosis (of which the majority are considered ‘idiopathic’), men will possess lower than expected average values for the three primary variables of any semen analysis, although variations within these test scores are possible. An important point is that thousands of men each year worldwide, who present with severe idiopathic asthenozoospermia and total sperm counts under 10 million, will not, however, possess an underlying genetic condition. Measures of fertility treatments are also likely to be effective in all other remaining sperm/hormone test results considered within the sub-fertile or mild infertile range, including azoospermic men with small test biopsies.
2.2. Factors Affecting Male Fertility
There are several factors that can influence male fertility. Some influences, such as age or exposure to endocrine disruptors , while others are lifestyle-related. There are some biological influences on male fertility that are beyond a man’s control. Firstly, it is widely acknowledged that female fertility declines as they age, and while there is less information around changing male fertility potential over time, there is still a general downward trend with age. The partners of aging men tend to be six times as probable to have a miscarriage than if the man is under 25 years of age. Exposure of a father to environmental endocrine disruptors can also elevate the risk of childhood illness in their offspring, including lower fertility.
A man’s overall health is likely to have the largest impact on his fertility, although the reasons for detrimental health effects on fertility are not yet fully clear. Rare inherited and acquired conditions in men can cause male infertility. For example, some intersex conditions can include having low levels of individuals diagnosed with Klinefelter syndrome of the genetic abnormality. In addition, men with Klinefelter syndrome will likely also have fertility problems. Lifestyle factors in men strongly influence male fertility.
For example, obesity is known to lower testosterone levels, and fathers with a high body mass index are less likely to have healthy children. Diet is also important. Studies of men show that a diet high in saturated fat is correlated with having a lower sperm count, as is irregular exercise. Given that a man’s overall health holds such significant influence on his fertility potential, the male role in fertility should be acknowledged and men should be taking a proactive approach in seeking fertility healthcare. Increasing men’s awareness of these factors and how they influence fertility will help them be more active in protecting their reproductive health. Fertility testing can help men develop this awareness.
It is well known that male fertility declines with age, albeit more gradually than in women, and that various health issues can influence male fertility, including overall physical health, diet, exercise, lifestyle factors, mental health, and genetics. Just as with women, pre-conception health should be part of standard disease prevention for men. The male partner’s influence on pregnancy preparations is often determined from the perspective of his potential harmful behaviors and the risks these pose to a child and future pregnancy. His potential influence regarding healthy lifestyle and health awareness is typically not addressed proactively in healthcare or society.
3. Importance of Fertility Tests in Couples
Fertility testing within couples can play a crucial role in family planning, especially in the context of seeking help for infertility. Typically, both partners would embark on the journey of fertility testing to fully understand their ability to conceive. Knowing a woman’s fertility does not provide an overview of the full conception picture. Further, knowing a man’s fertility again does not provide a full overview. It is very important to undertake comprehensive fertility testing for both men and women. Some couples would prefer to first check the woman, whereas others prefer to check the man first. In any case, both parties should be considered equally in the first step of attempting to conceive. By comprehensively checking both male and female fertility, the unique interplay of sperm and egg and other factors, such as hormonal or genetic factors, can be identified. With an understanding pertaining to fertility in both males and females, options such as the best form of IVF or ICSI, donor sperm, preimplantation genetic testing, egg freezing, sperm freezing, or adoption further down the line can be considered through a comprehensive discussion and counseling with your fertility clinician. Going forward from fertility testing leads to reproductive treatment and successful pathways in starting your family. Even if the results from your fertility tests are negative, this in itself is a piece of information and can provide peace of mind and relief from uncertainty
Knowing your fertility levels, or lack thereof, can lead to constructive emotional benefits and gather support from those around you. It can lead to less conjecture and cause partners to feel open and honest about their future and what they can expect. By not speaking about the fertility test and their associated results, it can start to create a world of guesswork around the future of family creation and silence between partners. Ultimately, fertility testing is a big step in embarking on the journey to start a family and is bigger than purely a measurement or finding. It is a moment to measure where both a couple’s reproductive health is and start on the big team effort of conquering fertility challenges together.
4. Future Directions in Fertility Testing
With the growing concern in developed countries about women delaying childbearing, researchers and policymakers are focused on the need for robust and accurate tools to help women make well-informed decisions about their fertility and planning for motherhood. Despite the need for fertility information, it is recognized that many women, and even their healthcare providers, are not clear about how fertility tests work and how their results should be interpreted. Until the medium- and long-term performance of these tests has been evaluated more thoroughly, and evaluated in the context of their use as guideposts for making important life decisions, the potential for these new tests to benefit women who, for whatever reason, wish to delay childbearing cannot be realized. It is hoped that further research will determine the benefits of fertility testing for women. Lessons learned from the validation and long-term follow-up of these tests in women might also benefit men. Currently, no population-based data have been published on the relationship between male fertility testing and success in fatherhood achieved by the age of 45–50. If effective testing for sperm is available, it would be possible to consider specific measures to help improve the fertility of individuals found to be at risk or to guide male fertility preservation. Whether such early intervention strategies aimed at specific target groups would fulfill a therapeutic need remains to be determined. What is evident is that current technologies offer major shortcomings for the long-term cryopreservation of human spermatogonial cells, but this may change in the future. The generation of new opportunities for men who wish to delay fatherhood would both reflect increased interest and improve their capacity to father children in the event of age-related infertility.
References and resources
Mayo Clinic – Overview of fertility tests for men and women.
Mayo ClinicAmerican Society for Reproductive Medicine (ASRM) – Fertility evaluations and factors affecting fertility.
ASRMNational Institutes of Health (NIH) – Research on male and female infertility causes and tests.
NIHCDC – Infertility FAQ – Common questions about fertility testing and treatments.
CDC
