Fertility Testing for Lesbian Couples or Anyone Using Donor Sperm
If you are trying to conceive using donor sperm, getting a fertility work up early in the process is a good idea. If there is an issue that will impact your fertility, it’s better to know about it through fertility testing before investing your time and money on sperm and artificial insemination (AI).
Recommended Fertility Testing
- Eggs – hormone levels and ovarian ultrasound
- Sperm – semen analysis
- Uterus – imaging
- General health markers that impact fertility
Eggs
Eggs have two components that affect fertility – quantity and quality. Quantity can be seen with an ovarian ultrasound. Both the quantity and quality of the eggs can be evaluated with hormone levels, which are measured by blood tests.
Anti-Mullerian Hormone (AMH)
- measures the quantity of eggs
- tested at any time in the cycle
- optimal range: 1 – 5
Follicle Stimulating Hormone, (FSH)
- assesses the quality of eggs
- tested on cycle day 3
- evaluate with estradiol level
- optimal range: less than 10
Estradiol (E2)
- measures the quality of eggs
- tested on cycle day 3
- evaluate with FSH level
- optimal range: 20 – 80
Luteinizing Hormone (LH)
- tested on cycle day 3
- used to diagnose PCOS (Polycystic Ovarian Syndrome)
- evaluate with FSH level
- optimal range: same as FSH level
Sperm
Sperm are tested with a semen analysis. A healthy sample has a lot of sperm (concentration), and they can swim (motility). Numbers will vary depending on a fresh or frozen sample.
If you are working with a sperm bank, they will have completed the analysis. If you are working with a known donor, complete a semen analysis and have the sperm donor screened for STDs such as HIV.
Uterus
The health of the uterus is determined using imaging. There are two standard diagnostics that are performed for everyone:
Ultrasound
- identifies issues such as polyps and fibroids
- measures the uterine lining
- assesses the number of eggs
Hysterosalpingogram (HSG)
- determines if the fallopian tubes are open or blocked
- evaluates the shape of the uterus and screens for issues such as a septum
- tested on cycle day 7 – 10
General Health Blood Tests
Thyroid Stimulating Hormone (TSH)
- measures thyroid function
- abnormal thyroid function is linked to a higher risk of miscarriage, especially in the first trimester
- optimal levels: below 3.0
Prolactin
- evaluates the hormone that supports lactation
- abnormally high levels interfere with healthy egg maturation and disrupt ovulation
- normal range: below 30
Fasting Glucose, Hemoglobin A1c, Cholesterol
- screens blood sugar abnormalities
- elevated blood sugars are the most common cause of infertility through a variety of mechanisms, including: poor egg maturation, lack of ovulation, poor implantation of the embryo, pregnancy complications, and PCOS.
Hemoglobin and Ferritin
- measures iron which plays an important role in the transport of oxygen throughout your body by red blood cells.
- low levels of iron are associated with anemia, which in turn contributes to pregnancy complications, including: premature delivery, low birth weight, and postpartum depression.
Vitamin D
- normal levels promote healthy egg maturation
- low levels are associated with a higher risk of miscarriage
- optimal range: 50 -80
How to get this testing done
A fertility specialist can guide you through your fertility testing work up and help interpret the results.
This information can support you to make informed decisions that directly make an impact on your fertility journey.
If you live in the Bay Area and are looking for family building support, please contact us.
Leslie Oldershaw, L.Ac., FABORM
Medical director
Fertility Acupuncturist East Bay
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