Crucial Lab Tests to do before Treating Infertility
Updated: Oct 1, 2020
There is an old saying I always think about when I talk about this topic: “if you have an hour to cut down a tree, spend the first 1/2 hour sharpening the axe.” I love this saying because it reflects perfectly how to best approach fertility, in the sense that correctly identifying all variables and factors that are reducing a couple’s chances of successfully conceiving accurately allow for a personalized treatment plan. Before jumping in to a fertility treatment, it only makes sense to check for any reasons that may be reducing your likelihood of conception.
Our idea of what is ‘normal’ for fertility testing needs to be reexamined. The fact that ‘Unexplained Infertility” is continuing to become a more common diagnosis, we need to accept that we are missing some tests to screen for all possible causes of the infertility. Typical fertility testing will catch a lot of the big causes: fibroids, polyps, blocked tubes, a severe deficiency in sperm quality, STIs, etc. But we have more clinical evidence and research finding that things like thyroid autoimmunity, elevated stress, poor follicle integrity, elevated sperm DNA fragmentation rates, mild-to-moderate polycystic ovarian syndrome can often be present without diagnosis even after many years of fertility treatments. Even some of the big causes of infertility can take years to diagnose in Canada, for example, PCOS can take up to 7 years to be accurately diagnosed from the first appointment where a patient presents with symptoms to their family doctor.
Additionally, more research has shown that one of the large drivers of low egg quality is actually related to poor insulin sensitivity (and poor blood sugar control as a result) as it can increase oxidative stress. This is a small example of something that may not be checked, and we often find that patients who have been trying to conceive for years unsuccessfully after being diagnosed with unexplained infertility may have some of these tests come back as positive.
Sperm health and fertility is a whole chapter on its own. Patients are often surprised to learn how low the bar has been set for sperm to pass as ‘normal.’ In the 90’s we used to estimate that a healthy sperm sample should have 80% normal sperm morphology, by the 2000s it came down to about 50%, today that bar is at just 4%! It is true that low sperm morphology does not seem to affect IVF success rates, but it does correlate with increased sperm DNA fragmentation, which has been shown to increase the risk of miscarriage and potentially increase the risk of congenital abnormalities in the offspring (heart malformations, cleft palate, schizophrenia, autism) and certain paediatric cancers. Additionally, healthy sperm morphology may still play a significant role in chances of natural conception.
Therefore we have produced a list of the most common additional testing we pursue for patients depending on their presentation and medical history. Use the link below to download for free.
This article is in no way a replacement for medical advice or medical care, it is advised that anyone concerned about their Health should speak with their Naturopathic Doctor. Please discuss with your healtcare provider and only make changes to your medications regimen if recommended by your doctor and under their guidance.