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Fertility Testing for Assigned Females at Birth

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If you’re considering fertility treatment, a comprehensive assessment and testing is often an essential first step. The results help your medical team to create a custom fertility plan that is unique to you and your goals for your family.

But there are so many tests out there, so where do you start? Not to worry — during your first visit with your TRIO team, your fertility specialist will review your medical history and concerns. This initial consultation will help them determine which tests are right for you.

In this article, we outline some of the most common fertility tests, why they are recommended, what to expect, and how they might help inform your fertility plan.

The Most Common Fertility Tests in Assigned Females at Birth

Ovulation Testing

Absent or irregular ovulation can make it difficult to become pregnant. Your TRIO doctor may check your ovulatory patterns as part of your initial fertility screening. For example, your levels of progesterone on days 19-22 of your menstrual can show if you have ovulated that month.

Ovarian Reserve Tests

Ovarian reserve is the number of eggs in your ovaries and testing your levels is an important step when planning your fertility treatment.

Depending on your medical history, you may require one or more of the following ovarian reserve tests:

  • Anti-Mullerian Hormone (AMH): AMH is a hormone produced by the eggs in your ovaries. For example, a high AMH level suggests you have a good ovarian reserve. Your AMH can be checked at any point in your menstrual cycle.
  • Follicle Stimulating Hormone (FSH): FSH encourages your ovaries to develop eggs and produce the hormone estrogen. For example, a high FSH level on day 3 of your cycle may suggest a reduced ovarian reserve.
  • Antral Follicle Count (AFC): An AFC test enables your TRIO doctor to count the number of follicles you have in your ovaries. This is performed using an internal ultrasound scan on days 2-4 of your cycle.

Fallopian Tube Patency Testing

The fallopian tubes connect the ovaries to the uterus and are where fertilization occurs. Depending on your medical history, your TRIO doctor may wish to check the patency (openness) of your fallopian tubes. A blockage along the fallopian tube can stop fertilization and can increase your risk of ectopic pregnancies.

  • Sonohysterogram: A small amount of saline solution is used to fill the uterus. An ultrasound scan lets your TRIO doctor assess if the fallopian tubes are open.

Uterine Tests

The uterus is the site where a fertilized egg (embryo) will implant and develop into a baby. It’s important to check the health of your uterus before starting fertility treatment. Most uterine tests take place on days 6-12 of your cycle under a general anesthetic, for your comfort. This means you will need someone to drive you home after your procedure.

There are several uterine tests available. Depending on your medical history, and the results from other fertility tests, your doctor might recommend one or more of the following:

  • Sonohysterogram: A small amount of saline solution is used to fill the uterus. An ultrasound scan lets your TRIO doctor assess the health of your uterine cavity.
  • Hysteroscopy: A camera is inserted into the uterus to check for any abnormalities like scarring or growths.
  • Endometrial biopsy: If your TRIO doctor wishes to check the health of the uterine cells more closely, they may take a small biopsy which is analyzed by a special laboratory.
    • Endometrial Receptivity Array (ERA): A small biopsy of uterine tissue is taken to check how receptive the uterus is to support embryo implantation
    • EndomeTRIO: A small biopsy of uterine tissue is taken to assess the receptivity, microbiome (bacterial flora), and inflammation status of the endometrium to check if it is supportive of embryo implantation.
  • Matris™ Ultrasound: The Matris™ system is a specialist ultrasound that assesses the quality of your uterine lining and predicts the probability that you will become pregnant if you were to have an embryo transfer.

Additional Hormonal Testing

Based on your medical history and the result of your other tests, your TRIO doctor may decide to monitor additional hormones which can affect fertility. These may include:

  • Prolactin: High levels of this hormone can negatively affect fertility by preventing ovulation.
  • Thyroid Hormone: If your thyroid hormone levels are too high or too low, it can affect ovulation and cause irregular periods. If your thyroid hormone levels are out of balance, it can also suggest an underlying health condition that could affect your fertility (or pregnancy).
  • Testosterone: If your testosterone levels are too high or too low, it can negatively alter your chances of a successful conception by interfering with egg development.
  • DHEAS: DHEAS is a hormone that the body converts into estrogen. If you have low levels of DHEAS in your body, you may not produce adequate levels of estrogen to support egg development.

We understand that there’s a lot to understand with fertility testing. At TRIO, we’re here to answer your questions and support you on your fertility journey. Want to learn more about fertility testing? Speak to a member of our team today!