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Our last blog detailed how to read your at-home fertility results. If you’ve recently taken an at-home fertility test and the results weren’t what you expected, or something was out of whack, you may be wondering what to do with that information. This blog is the last in our four-part series that explores everything you’ve always wondered about testing your fertility at home.
This series includes:
First things first. Stop. Now, breathe…
A less-than-normal result doesn’t mean you’ll never have kids. Abnormal results are not uncommon with fertility testing, and if you have one, there are things you can do to get your levels back within the normal range.
If your fertility results aren’t perfectly within normal range, don’t panic! Realize that at-home fertility testing is just one tool that can help you identify hiccups early on. Although we believe in the accuracy of Orchid test kits, it’s still important to recognize that it’s normal for hormones in our bodies to fluctuate. Hormones in a woman’s body can be particularly unpredictable throughout the phases of the menstrual cycle. And men’s semen samples can vary greatly with each ejaculation, dependent upon many circumstances.
My Virtual Physician has partnered with Orchid to provide synchronistic support to patients who test their fertility at home with Orchid tests. Our online OBGYNs can help interpret your results and guide you through steps to take to improve your fertility. If you have an abnormal result, we recommend a virtual visit with our physicians. We may encourage re-testing during a different point in a woman’s cycle or after a few lifestyle changes are introduced. Certain medications can help correct some infertility problems. Next, let’s cover some common abnormalities that both men and women might find on their at-home fertility test results.
There are two main culprits of infertility for couples:
Evidence that a woman is experiencing a problem with ovulation can be shown in abnormal fertility results. In particular, an abnormal follicle-stimulating hormone (FSH) level in women can indicate a problem. Higher than average levels of FSH can mean that a woman’s body is having trouble bringing eggs to maturity. On the other hand, low FSH levels might mean that you are not ovulating.
Luteinizing hormone (LH) is another chemical that indicates ovulation in women. Abnormal LH levels can mean that a woman is not ovulating. Many disorders, including PCOS, may cause a woman’s LH levels to be high and affect fertility. Low LH can happen if your BMI is too low.
Abnormal prolactin levels in women are a common cause of fertility troubles. Non-pregnant women should have very low levels since the hormone is primarily used for milk production in nursing mothers. If you have a high prolactin level, it can hinder your fertility if not corrected.
Men who have an abnormal semen analysis should repeat the at-home fertility test before taking action. There are a few common problems that can show up in a semen analysis, including:
The results are in, and now you can start working to correct any abnormalities that showed up on your at-home fertility testing. Below we cover some common solutions to abnormal fertility values.
Women with abnormal FSH levels may be advised to change medications or start a new medication in order to bring their levels into the normal range. Medications can also be used to correct abnormal LH levels. Lifestyle changes affecting your weight may also improve LH levels for some women. Your doctor may want to run further tests to rule out other disorders that could affect your LH levels.
High prolactin levels can be reduced with medication. Sometimes further testing is required to confirm the cause of the increased levels. Abnormally low prolactin levels may not need to be treated.
Low sperm count in men is the most common abnormality found during fertility testing. It can be caused by many things, including certain medications, untreated diabetes, or hormonal imbalances, among others. Solutions may include testing for and managing these conditions or switching medications.
Abnormal sperm movement can be caused by alcoholism, toxins, smoking, and some medications. Lifestyle changes are often required to correct this abnormality.
Your doctor may run additional tests for men with two abnormal results, including at-home hormone testing for men, which is available through Orchid. Other tests include advanced semen analysis or genetic testing.
At-home fertility testing can be an effective way to reassure yourself that your body is in proper working order. But if the results come back abnormal, which is not uncommon, there are steps you can take to get things back to normal. With early, at-home fertility testing, you now have more time to correct abnormal levels before they become a problem. So, when you’re ready to start your family, your body is ready when you are.
Listen to your instincts; we all have them. Without them, we likely wouldn’t have made it this far as a species on this planet. Survival instincts protect you from pain and danger, while reproductive instincts encourage procreation–ensuring the long-term survival of humans. It’s the natural cycle of life; primitive instincts drive the survival of the human species. That’s why you’ve always been curious about your fertility. This blog is part of a four-part series where we explore everything you’ve always wondered about your fertility.
This series includes:
Fertility is your natural ability to reproduce; in other words, to conceive and give birth to new life. In its basic form, fertility is the ability to have sex that results in the uniting of sperm and egg, brought to fruition as a newborn child. It’s a natural instinct to have the desire to reproduce, just like it’s a natural instinct to eat food to survive. That’s why it can be so devastating when you are unable to get pregnant.
When you consider all of the factors required to produce new life, it’s a miracle that couples are able to become pregnant at all. Both parties play a role in fertility. You cannot conceive if one of the two is not fertile.
For a woman to be fertile, that means her body has to:
For a man to be fertile, his body has to:
To complicate matters even further, you may have heard that you’re only fertile during certain times of the month. That’s true for women, who comprise half (or arguably more than half) of the equation. A woman’s body is only fertile during ovulation, when the egg is released into the fallopian tube, awaiting fertilization. This period is called the fertile window.
To increase your chance of conceiving, it’s best to have sperm waiting in the fallopian tube before ovulation happens. There’s only a brief period of 12 to 24 hours from the time the egg is released for it to unite with sperm. Since sperm can live for up to five days inside a woman’s reproductive system, that leaves you a fertile window just short of a week.
There are about six days each month that a woman’s body is most fertile. Your body works in cycles, so your ovulation takes place on a cyclical basis. For most women, the entire menstrual cycle takes 28 days to complete–from the first day of each period to the next. Ovulation calculators can help you determine which days you’re most fertile each month and can be adjusted based on your average cycle length. It works like this:
Related: Natural Birth Control: Fertility Awareness
As you can see, fertility is complicated. There’s a multitude of factors that must align in order for conception to happen. So, if you’ve struggled to get pregnant as quickly as you had hoped, you’re not alone. Or maybe you haven’t tried, but are a little surprised that you haven’t had an unplanned pregnancy by this point in your life–leaving you wondering if you’re infertile after all. Should you be worried when the time comes to try? Are there things you can do to be proactive in your fertility? These are all valid questions.
Even if you have no signs or risk factors for infertility now, you might still be curious. Nearly 20 women out of 100 women without children continue to see negative pregnancy test results after a full year of unprotected sex. Sadly, infertility is a common problem for couples. Some factors can increase your risk of infertility, validating your need to find out now whether you are fertile. Some risk factors for infertility include:
Whether you have any of these risk factors or not, you still want to know more about your fertility. The good news is, there’s a way to find out. You can skip the one-year wait that most doctors will require with Orchid at-home fertility testing.
Your curiosity about your fertility is healthy; it’s instinctive. You can ease your mind today with at-home fertility testing, which can give you definitive answers about the mystery of your fertility. My Virtual Physician has partnered with Orchid to provide professional-grade at-home fertility testing to our patients. Our next article will cover how to test your fertility at home.
Stefanie:
Welcome, everyone! Thank you for joining us today.
My name is Stefanie and I'm part of the team here at MyVirtualPhysician. We are a direct to consumer, multi-specialty, telemedicine provider operating in multiple states.
It is Talk Tuesday and we are continuing our weekly educational series, talking with our experts, exploring some common healthcare concerns that we see, and hopefully answering some questions you may have.
Today our physician expert is Dr. Salome Masghati, a practicing gynecologist and minimally invasive surgeon and one of our telemedicine providers. We are talking about a problem that may affect one in ten couples at some point, Infertility.
Dr. Masghati thank you for joining us today.
Let’s start by talking about what is Infertility?
Dr. Masghati:
Infertility is a diagnosable medical condition in which a couple has been unable to conceive a pregnancy despite unprotected intercourse.
Stefanie:
Can you tell us some of the causes of Infertility?
Dr. Masghati:
Infertility in women can have many different causes, such as abnormal ovulation, pelvic inflammation, endometriosis, hormone abnormalities, tubal scarring etc. Infertility in men is commonly caused by problems with sperm cells. Aside from these physiological causes, factors affecting fertility can include age, health status, and lifestyle factors such as stress, diet, or smoking. They work to keep you healthy later if you are exposed to a live virus. Marijuana use and heavy drinking have also been shown to cause decreased sperm motility in men.
Stefanie:
So when should a couple seek a medical opinion about getting pregnant? Is there a time frame, say?
Dr. Masghati:
The general rule of thumb is one year for women under the age of 35, and for women over the age of 35 they might seek a medical opinion sooner, after maybe six months of trying to get pregnant. Other reasons to see a doctor when planning a pregnancy might include history of miscarriages, men who have trouble maintaining erection or women with irregular menstrual cycles. Also couples who have had sexually transmitted infections and are now unable to conceive a pregnancy may need to see a doctor, and individuals who have been exposed to toxic chemicals or chemotherapy as in the case of a childhood cancer or something of that nature.
Stefanie:
When couples seek help for infertility concerns, what can they expect?
Dr. Masghati:
Usually the doctor will start with a history and physical, and then they may order blood or urine testing, hormone testing. The doctor may evaluate both partners to try to determine if there are any abnormalities, and then they will go over test results and recommendations with you. Some of these tests can be ordered by me through My Virtual Physician visits, but some need to be followed up in person with a physician in the office.
Stefanie:
And after this evaluation, what sort of treatment options might be recommended, or are available?
Dr. Masghati:
There are medications available for men and women that can increase chances of getting pregnant. Intrauterine insemination, or IUI, is a procedure in which a physician can insert sperm into the uterus at the time of ovulation to help with conception. And for other cases, fertility specialists may offer in vitro fertilization, known as IVF, which is a surgical procedure in which a woman’s eggs are retrieved, fertilized, and then transferred back into the woman’s uterus.
Stefanie:
What is the success rate of a procedure like in vitro fertilization?
Dr. Masghati:
Women under the age of 35 can expect about a 50% success rate for in vitro fertilization, but it is a very complex process that requires intense testing and monitoring and can be costly, anywhere for $20,000 - $50,000.
There is also the possibility to address infertility issues through functional medicine, which is a type of medicine where we look at the patient in a more holistic approach. Functional medicine and integrative medicine can be helpful to couples who have been unable to conceive.
Stefanie:
Dr. Masghati, you have shared some great information today and answered questions that I think many couples may have on their minds. I appreciate you joining us for Talk Tuesday and telling us what we need to know about infertility. For everyone else joining us as well, this has been Talk Tuesday with My Virtual Physician. If you would like to connect with one of our board-certified OB/GYNs, or for more information, you can check out our website at www.myvirtualphysician.com. We look forward to seeing you again and we hope you have a great week.
Starting a family is a goal for many couples. Unfortunately, one in ten couples may have some difficulty getting pregnant and require medical treatment. If you've been affected, you might be wondering about infertility: when is it time to see a doctor? My Virtual Physician has board certified physicians who specialize in infertility and are available for virtual doctor visits.
Infertility is a diagnosable medical condition in which a couple cannot conceive a pregnancy despite unprotected intercourse. It can be caused by many factors.
In women, most often, abnormal ovulation causes infertility. In men, usually problems with sperm cells, such as sperm count or function, cause difficulty conceiving.
Aside from these physiological causes, factors affecting a couple's fertility include their age, health status, and lifestyle factors such as stress, diet, or smoking.
According to the American College of Obstetricians and Gynecologists, women who are overweight, underweight, or exercise too much may have difficulty getting pregnant, and men who are heavy drinkers or smoke marijuana since these are known to lower sperm count and movement.
In some cases, doctors cannot determine the cause and refer to these cases as unexplained infertility.
Generally, it is time to consult your physician about getting pregnant if you are under the age of 35 and have been unable to conceive after one year of unprotected sex. Women over the age of 35 and those who have irregular menstrual cycles or have known abnormalities with their reproductive system, should talk with their doctor much sooner, after six months.
Infertility affects both people in the relationship. There is a 30% chance the infertility is related to male factors in a traditional couple, 30% related to female factors, and a 30% chance a combination of both factors. Therefore, anyone in the relationship may need to discuss options for starting a family. Here are some reasons to see a virtual doctor:
When you consult your physician about infertility, you can expect that they will begin your care with a complete history and physical exam. They may order blood testing, urinalysis, hormone tests, or other diagnostics to check for abnormalities. It may be necessary to have your partner undergo an exam and diagnostic testing also. Your physician may order an ultrasound or an X-ray as well.
After all of the tests, you will meet with your physician to discuss the results and go over treatment options and recommendations. After you decide on the treatment plan that is best for you, you will receive support and guidance in your process to get pregnant.
Medical treatment and new technologies can increase your chances of getting pregnant. One or both partners in a couple may undergo treatment.
Medications may be taken by mouth or injected. There are drug therapies for both men and women aimed at increasing egg production or sperm count. A list of medicines frequently prescribed for infertility treatment can be found here.
In some cases, blockages, scar tissue, or abnormal growths require surgical intervention. Procedures may be laparoscopic: meaning performed through small incisions in the abdomen for a minimally-invasive procedure.
Today, the two most common infertility treatments are intrauterine insemination (IUI) and in vitro fertilization (IVF).
IUI is a procedure during which a physician injects sperm into the uterus at the ovulation time. This method is least invasive and most cost-effective but has lower success rates. The estimated success rate is 10-20% for a single cycle of IUI, but additional rounds increase chances, and in three to six cycles, the success rate is up to 80%.
IVF is a complicated procedure requiring surgical retrieval of a woman's eggs, fertilization in a laboratory, and then transferring the fertilized eggs back into the uterus. Women under the age of 35 can expect a 50% success rate for IVF treatment, but this process requires intense testing and monitoring and can cost $20,000 to $50,000.
Starting a family can be challenging, and your physician may offer options to guide you through the process. Infertility is a medical condition that affects many couples, and there are treatments available.
Need to talk to a physician now? My Virtual Physician has Board-Certified OB/GYN's that are available for virtual doctor appointments and are able to answer any questions you have and guide you in the right direction. The online doctors at My Virtual Physician, not only address infertility and reproductive endocrinology, but also irregular periods and painful periods, and many more gynecological conditions.
If you still have questions or you would like to discuss your problem with our board-certified OB/GYN specialists, click below to schedule an appointment. My Virtual Physician treats conditions, including infertility, irregular periods, sexually transmitted infections, and more. If you have any suggestions for additional topics you want to read about, let us know! Don’t forget to check out our podcasts for more and follow us on social media.
