Your TTC Strategy 1: Prepare to Be Pregnant

Not all couples seeking fertility assessment are ready to conceive immediately. Some just want to know for their own peace of mind that there are no obstacles to conceiving. Others, who have delayed childbearing, want to know if they still have enough eggs and sperm. While no method of testing is 100 percent accurate, there are many approaches from low tech to high tech that provide valuable information.

Low-Tech Methods

For both men and women it is important to assess risk factors that may interfere with conception. Potential problems for women include a history of cancer treatment, endometriosis, sexually transmitted infections, age, polycystic ovarian syndrome, smoking, early menopause, and prior abdominal or pelvic surgery. Men should be concerned about age, chemical exposure, heat exposure, prior cancer treatment, certain prescription medications, sexually transmitted infections, surgery on reproductive organs, varicocele, and smoking.

A woman's menstrual patterns provide an indication of fertility potential. If periods occur regularly every 28 to 32 days, if ovulation predictor kits indicate ovulation, if there are some premenstrual symptoms, and if she experiences mild to moderate cramps it is quite likely that she is ovulating and producing an egg each month. The absence of these signs and shortening or lengthening of menstrual cycles may indicate a problem.

Over-the-counter fertility testing has recently become available. The male fertility test assesses the protein content of a semen sample to determine whether the sperm density is satisfactory. Other tests assess the sperm motility. For women, a test is available to measure follicle stimulating hormone (FSH), which gives an indication of the number of eggs in the ovary (ovarian reserve). The accuracy of the results from these tests are only as good as ability of the person to read directions and perform the tests properly.

High-Tech Methods

These tests are performed by a health care provider and have a much better ability to predict fertility. Many of these tests are used to assess infertility, but they can just as easily be used by those contemplating pregnancy.

Semen analysis Semen analysis is probably the first test that is performed in men. This test determines the number of sperm and the proportion that are motile. If there are an inadequate number of sperm, additional testing may consist of an examination by an urologist, blood tests to measure hormones, chromosomal analysis, testicular biopsy, and tests to see if there are any blockages to sperm transport.

If the sperm are not moving well, you may be tested for the presence of anti-sperm antibodies, varicocele, or prostatitis. No single sperm feature can accurately predict fertilization or pregnancy potential so tests to predict whether the sperm are able to fertilize an egg are sometimes used and include a computer-assisted semen analysis, induced-acrosome reaction testing, sperm penetration assay using hamster eggs, and sperm-zona pellucida binding assays. The clinical usefulness of specialized sperm testing remains controversial.