Checking Female Fertility: What to Know About Testing Cost & Accuracy

When it comes to understanding female fertility, there is often confusion surrounding the various tests available, their accuracy, and what they truly measure. Female fertility testing can be a valuable tool for individuals and couples seeking to understand and check their reproductive potential. However, it's crucial to dispel the notion that these tests directly measure fertility - what they’re primarily evaluating is ovarian reserve, which provides insight into the quantity of eggs offered up each month of your cycle. After all, whether or not you are “fertile” often comes down to whether or not you are ovulating with a regular menstrual cycle. That said, the only conclusive test for fertility is if you are able to achieve and sustain a pregnancy without assisted reproductive technologies. 

To help demystify female fertility tests, let’s discuss the different tests available, their costs, their accuracy, what information they provide, and when they can be useful on your family-building journey.

To start, we can think about natural conception. To have a healthy pregnancy, the female partner must ovulate a chromosomally normal egg, her fallopian tubes must be open to receive the egg and provide a place for fertilization to occur, and her uterus must be a hospitable home for an embryo to implant and begin to develop. 

Understanding Female “Fertility” Testing:

When you hear someone refer to female fertility testing, what they’re often actually referring to is an assessment of ovarian reserve, which reflects the quantity of eggs available for fertilization. It is important to note that these tests do not directly measure fertility or the ability to conceive

Understanding female fertility testing is crucial for individuals and couples navigating their reproductive journey. These tests evaluate ovarian reserve rather than fertility directly. It is important to recognize that a normal menstrual cycle and active attempts to conceive provide the truest indicators of fertility. When seeking fertility testing, individuals should consult with a healthcare professional to determine the most appropriate tests for their unique circumstances. 

If your provide believes that there might be an underlying issue preventing conception, tests such as a saline sonogram or HSG can be performed to determine if there are any abnormalities or blockages in the fallopian tubes or uterus that are preventing natural fertilization and implantation.

The Egg - Ovarian Reserve & Its Significance:

Ovarian reserve refers to the quantity of a woman's eggs (oocytes) that are available for fertilization. It provides an estimate of the reproductive potential and can influence the chances of conceiving naturally or with fertility treatments. Several factors affect ovarian reserve, including age, genetics, and certain medical conditions. While ovarian reserve assessment gives helpful data around your reproductive potential, it should not be considered a determinant of fertility, but rather a determinant of how successful an egg freezing or IVF cycle could be, should you decide to pursue fertility treatment on your path to parenthood.

Available Tests for Evaluating Ovarian Reserve:

These are some of the tests available to check ovarian reserve, and what they measure: 

1. Anti-Müllerian Hormone (AMH) Test: AMH is a bloodwork test that measures the levels of a hormone produced by the ovarian follicles. It provides an estimate of the remaining egg supply. Costs typically range from $50 to $200, and brands such as Modern Fertility offer at-home tests that you can mail in to receive your results in some states. If you live or work in the New York City area, Spring Fertility hosts monthly, free AMH testing and fertility info sessions led by one of our physicians. You can learn more here.
   
   
2. Follicle-Stimulating Hormone (FSH) Test: FSH is also a bloodwork test and measures the levels of a hormone responsible for stimulating follicle growth. Elevated FSH levels may indicate diminished ovarian reserve. Costs typically range from $50 to $150.
   
   
3. Antral Follicle Count (AFC): AFC is an ultrasound-based test that counts the number of small follicles present in the ovaries. It directly assesses ovarian reserve and is often performed alongside other tests. Costs range from $200 to $400.

Accuracy of Ovarian Reserve Testing:

While ovarian reserve testing provides valuable information, it is not a definitive measure of fertility. The tests offer insights into the current state of the ovaries but cannot predict future fertility or the likelihood of conception.

When it comes to checking fertility, the only real way to uncover a potential issue is by actively trying to conceive with regular, timed intercourse. A normal menstrual cycle, typically between 21 to 35 days in length, suggests regular ovulation, enhancing the chances of conception. If a couple is under 35, an infertility diagnosis is made after 1 year of unsuccessful attempts at conceiving naturally. For women over 35, diagnosis occurs after 6 months. After the age of 40, it is recommending that you seek a fertility evaluation after 3 months of trying to conceive.

The Uterus: Saline Sonogram

A pelvic ultrasound is performed while sterile saline is gently instilled through the cervix and into the uterus. The saline neatly outlines the inside lining of the uterus The procedure takes about 10 minutes.

How it helps: Seeing the outline of the uterus allows us to detect any obstacles that could prevent a good embryo from implanting. Sometimes we find small abnormalities, like polyps, fibroids or scars that can be corrected before treatment.

The Fallopian Tubes - Hysterosalpingogram (HSG) or “The Dye Test”

The Hysterosalpingogram is a low dose x-ray of your pelvis to determine if your fallopian tubes are open. A radio-opaque contrast or “dye” is gently instilled into the uterus so that we can see the outline of your uterine cavity and fallopian tubes. The procedure takes only a few minutes and can be performed onsite at Spring, by our fertility specialists.

How it helps: The HSG tells us if the fallopian tubes are open or blocked. If they are blocked, then we will need to do In vitro fertilization (IVF) in order to bypass the tubes and help the egg and sperm to meet. If they are open, we may be able to try treatments like Intrauterine insemination (IUI).

Reproductive Health & Checking Female Fertility:

The ability to conceive naturally is influenced by multiple factors, including age, overall health, and reproductive history.

If you are having trouble conceiving, or just want to check in on your overall reproductive health before trying, a transvaginal ultrasound is a non-invasive imaging technique that allows for a visual assessment of the ovaries and uterus. While it does not provide a direct measure of ovarian reserve, it can identify potential issues such as ovarian cysts, fibroids, or structural abnormalities that may affect fertility.

A great first step in your family-planning is tracking your menstrual cycle to make sure you are ovulating regularly and that there aren’t underlying hormonal health issues. A normal menstrual cycle, typically between 21 to 35 days in length, can indicate regular ovulation and enhance the chances of conceiving naturally. Irregular menstrual cycles may be a sign of hormonal imbalances or other underlying conditions that can affect fertility. It is important to note that having a regular cycle does not guarantee fertility, and vice versa.

Cost of Female Fertility Testing:

The costs of fertility testing can vary depending on the healthcare provider, location, and additional services required. Costs for individual tests typically range from $50 to $400. At Spring Fertility, an initial fertility consult includes a transvaginal ultrasound (including AFC testing), an hour to talk to a doctor about your medical history and family-building goals, and plenty of time to have all of your questions answered.

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While fertility testing is a commonly used term, it is essential to understand that these tests primarily evaluate ovarian reserve rather than fertility itself. Tests such as AMH, FSH, AFC, and transvaginal ultrasound can provide valuable insights into a woman's reproductive potential and help guide fertility treatment decisions. However, it is crucial to recognize that a normal menstrual cycle and active attempts to conceive remain the most accurate indicators of fertility and any potential underlying issues. Consulting a healthcare professional or fertility specialist is advised for a comprehensive evaluation and personalized guidance regarding individual fertility concerns.