What Are Pregnancy and Fertility?

Fertility is the ability to conceive and produce a child. Pregnancy begins with the fertilization of an egg by a sperm cell, but male and female bodies must go through several steps for a healthy pregnancy to be possible. Some of the steps include:

1. Hormones trigger an ovary to release one egg in a process called ovulation.
2. A partner must produce viable and sufficient sperm.
3. As the egg travels through a fallopian tube to the uterus, it must encounter a sperm cell to be fertilized.
4. The fertilized egg must then get implanted in the lining of the uterus, where it can grow and develop during pregnancy.

If an egg is not fertilized in that cycle, the body sheds the egg and the lining of the uterus during menstruation.

Pregnancy is the period of fetal development, which usually lasts about 40 weeks from the last menstrual period to delivery.

The Role of Pregnancy and Fertility Testing

Fertility testing can be used to detect ovulation and/or to diagnose infertility, an inability to reproduce by natural means. This term is defined as not getting pregnant after one year of sex without contraception. Infertility is often due to a problem with one or more steps in the process of becoming pregnant.

Some types of fertility testing can help women know when they’re most fertile and plan for a pregnancy. A woman is most likely to get pregnant if she has sex during a window starting five days before ovulation (mid-cycle) to around 24 hours after. This is sometimes referred to as the fertile period.

Fertility testing can also help doctors diagnose the causes of infertility. Tests used to diagnose the causes of infertility include laboratory, imaging, and others that provide information about someone’s reproductive organs and the process of becoming pregnant.

Pregnancy testing can tell you whether you’re pregnant and if so, how far along in pregnancy you are. Prenatal tests during pregnancy can monitor the health of both you and your baby, including tests for genetic screening, fetal monitoring, gestational diabetes, STDs, and group B strep.

Who should get testing?

People who are experiencing infertility or who have underlying medical issues should speak to their physician to find out if they should get tested and which tests are indicated for their unique situation.

Fertility testing can help you plan for pregnancy, whether the goal is to become pregnant or to avoid pregnancy.

In addition to those already experiencing infertility, there are some risk factors to identify that may affect fertility. An infertility evaluation may be important when you meet one or several of the following risk factors:

  • Women over age 40
  • Irregular or absent menstrual periods
  • Family history of early menopause or premature ovarian failure
  • History of ovarian surgery
  • Advanced stage endometriosis
  • Uterine or tubal disease
  • Exposure to cytotoxic drugs or pelvic radiation therapy
  • Autoimmune disease
  • Smoking
  • Adult mumps
  • History of testicular trauma
  • Impotence or other sexual dysfunction
  • History of fertility issues with another partner

In women between 35 and 40 years of age without a risk factor, an infertility evaluation may be recommended after attempting to conceive for six months.

In younger people without risk factors for infertility, experts recommend trying to conceive for a year before having an infertility evaluation. People in this category may benefit from tracking fertility and timing intercourse with ovulation. A physician or reproductive endocrinologist can assist you in creating a tailored plan for fertility testing.

If you suspect you’re pregnant, you should get a pregnancy test, whether at home or from your doctor. During pregnancy, your doctor will recommend prenatal testing to monitor the health of you and your baby.

Types of Pregnancy and Fertility Tests

Fertility tests can help track ovulation to aid people in identifying the fertile period. Pregnancy and prenatal tests can diagnose and monitor the health of your pregnancy. The most common fertility and pregnancy tests include:

Pregnancy test

Pregnancy Test hCG (Human Chorionic Gonadotropin)

Estrogens test

Estrogens Test

LH tests

Luteinizing Hormone (LH) Test

More Pregnancy and Fertility Tests

Getting Pregnancy and Fertility Tests

Working with a doctor can help you determine the most appropriate fertility tests for your situation and can ensure that you understand fertility testing, that your sample is collected properly, and that the analysis is conducted by a certified laboratory. Insurance may cover fertility testing when it is prescribed by a physician.

While primary care physicians can perform fertility testing, patients dealing with infertility concerns may also find it helpful to locate a fertility specialist or obstetrician-gynecologist (OB-GYN) who is experienced in the evaluation and treatment of infertility.

Many types of at-home fertility tests are available. Doctors may recommend at-home urine testing of luteinizing hormone (LH) as a quick and helpful way to track ovulation. At-home LH testing involves testing a sample of urine to detect an increase in LH that occurs prior to ovulation. Some doctors my also recommend an Anti-Müllerian hormone or AMH test depending on the circumstances.

Fertility monitors used at home are digital devices that predict ovulation based on electrolyte levels in saliva, LH levels in urine, or a woman’s basal body temperature. At-home fertility monitors can store information over multiple menstrual cycles to help women better predict ovulation timing and plan for pregnancy.

At-home pregnancy testing is common, as many at-home tests detect levels of human chorionic gonadotropin (hCG) to determine pregnancy. You can get genetic, STD, and other types of pregnancy tests under your obstetrician’s care.

Costs of pregnancy and fertility tests

The cost of fertility testing will vary based on location and test type. Some clinics, such as community health centers, may offer lower-cost testing.

For women seeking to understand potential causes of infertility, at-home fertility testing kits are available that analyze samples of blood, saliva, or urine. Many at-home fertility tests attempt to give a broad picture of fertility by including multiple tests such as estradiol, LH, follicle-stimulating hormone, testosterone, and thyroid-stimulating hormone.

For men, an at-home semen analysis involves collecting a sample of semen and mailing it to a laboratory for analysis. Some at-home sperm tests give men the option of storing their sperm for an additional fee.

Although at-home fertility tests can help you plan for pregnancy, they are not a replacement for fertility testing prescribed by a doctor, which may give more accurate results.

At $47, a urine pregnancy test is slightly cheaper than a blood pregnancy test, which is $49.

For testing during pregnancy, a prenatal comprehensive package including several routine prenatal tests is $489.

Types of sample collection

The sample for a fertility or pregnancy test will depend on the particular test you’re taking. Blood, semen, and urine are the most common specimens used for fertility and pregnancy tests.

Getting test results

You may receive results of fertility and pregnancy tests during a follow-up appointment with your doctor, over the phone, or through online medical charts. It’s important to discuss fertility and pregnancy test results with a health care professional who can answer your questions and help you create a plan for moving forward.

Understanding the results of fertility and pregnancy testing can be complex, and decision-making may depend on the results of more than one test.

For at-home fertility and pregnancy testing, results may be available immediately, over the phone, or through a website or smartphone app. When using at-home fertility and pregnancy testing, it’s important to discuss results with your doctor to understand what they mean for your fertility and prenatal health.

Resources

These resources provide additional information about infertility and reproductive health:

Sources

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