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5 Tests to Get Done At The Beginning (That Aren’t Your Hormone Levels)

Updated: Mar 14, 2019

Whether you’re about to start on your fertility journey, or you deep in the midst of it, blood work and medical tests are par for the course.

At Natural Fertility, we’re big believers in conducting screening blood work at the beginning of any reproductive journey. Having a clear, definitive “Yes” or “No” about whether you need to get treatment for a particular imbalance is vitally important. Your time, money and energy are incredibly valuable, and having a clear diagnosis will provide you with a clear direction for treatment and more positive outcomes. In addition to a standard hormone check via a blood test, here are 5 tests you should absolutely do at the start of your fertility journey.

  1. A Semen Analysis For Your Partner

  2. Comprehensive Thyroid Evaluation

  3. Iron Levels

  4. Vitamin D Levels

  5. Fasting Insulin

A Semen Analysis For Your Partner:

So why is semen analysis at #1? Because 30% of the time, infertility is due to a Male Factor. Far too often, the female partner will go through months or YEARS (!) of testing and treatment before her partner steps foot in a doctor’s office. At which point they may discover she really didn’t need to do much at all while her partner should have been treated with testosterone, HCG or even gotten a surgical procedure done. Also? A sperm count isn’t good enough. Motility and morphology are critical and give us great insight into the health of the DNA in the gametes. Most Reproductive Endocrinologist will tell couples you only need one sperm to get pregnant and while theoretically true, ideally you and your partner can do better that one single sperm!

It’s also very important to be tested more than once. The World Health Organization recommends two semen analysis’ be completed, a week apart, to determine a man’s fertility status. Azospermia (zero sperm) and Oligospermia (low sperm count) will require extra work up. Sometimes it can involve hormone testing and other times men are referred to Urologists.

Comprehensive Thyroid Evaluation:

A comprehensive thyroid evaluation includes a TSH, free T4, free T3 and both Thyroglobulin and Thyroid peroxidase antibodies. Why? Because you can have Hashimoto’s (link to another article) with elevated antibodies mucking up your reproductive hormone even if your TSH is normal! Also, your TSH had better be between 0.5-2.5 and if your doctor isn’t willing to treat you until your TSH normalizes, get a new doctor. This is too easy of a fix with a low risk of side effects. Often doctors are reluctant to test and treat ‘subclinical’ hypothyroidism because of a philosophical objection to not treat if test results are “normal”. You would be floored at how many doctors don’t know that a TSH higher than 2.5 correlates with a higher risk of miscarriage. Again, if you have a doctor that won’t test or won’t treat you, find a new doctor!

Iron Levels:

Normal iron levels are critical for optimal function of the thyroid. In fact, a diagnosis of subclinical hypothyroidism should always involve testing a person’s iron levels. Most yearly check ups (if there is blood work ordered) just involve a CBC (complete blood count) and while this can tell us about some types of anemia, I always order a ferritin level as well. This will show me how much iron is being stored by the body. I’m amazed how often women come to me completely exhausted, only to find they have very low ferritin levels. Remember there are lots of reasons why you might tired and this is an important one to rule in or out.

Vitamin D:

OK, this is technically a hormone, but it’s often overlooked by conventional doctors. Vitamin D, when paired with B12 levels can tell us a lot about your nutrient levels. If they are suboptimal, that means your cells aren’t getting the nutrients they need, which are easy fixes!

Fasting Insulin:

This is important for so many reasons!! Did you know elevated insulin levels can be the first marker for pre-diabetes? It can also lead to increased abdominal fat that just won’t go away and is one of the hallmarks of PCOS. Elevated insulin levels can disrupt the balance of hormones, causing an increase in testosterone and decrease in estrogen. When this shift occurs, it can also affect ovulation, causing to body to delay ovulation, forego ovulation or even cause abnormally small eggs.

So talk to your doctor. If they don’t listen or don’t agree, find a provider who does. Fertility and growing your family is too important (and can be too time-sensitive) a goal to put on the line.

Are you ready to kickoff your fertility journey?

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