$99 Fertility Check appointment
Predicting a women’s fertility potential, both now and in the future, is a challenging proposition. However, there are population studies and individualized laboratory tests that can help a woman know how fertile she may be now and what her chances of pregnancy may be in the future should she choose to wait to conceive.
At Reproductive Science Center, we take a personalized approach to advising women. Here’s how it works.
What is the Fertility Check?
The Fertility Check is a special offered by the Reproductive Science Center of the Bay Area to help women make an informed choice about when to have children. It includes a blood draw to assess your ovarian reserve, a written report and a follow up phone call by one of our physicians to review your results. This is a cash only procedure and not billable to insurance.
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What is included in the blood test and how is it reported?
With one simple blood draw, the AMH (anti Müllerian hormone), Estrogen and FSH (follicle stimulating hormone) will all be checked. The blood is drawn by one of RSC’s clinical staff and sent for analysis. Approximately one week later a nurse or physician will call to review the report and send you a written summary in a comprehensive, informative and easy-to-read report.
Who can or should test their fertility?
Women who are between the ages of 22-46 and currently have a regular cycle of between 20-40 days are ideal candidates for the Fertility Check.
What do the hormones tests show?
The Fertility Check measures the levels of a number of factors in the blood including the following ovary-related hormones:
- AMH (anti Müllerian hormone) is a protein released by the small follicles within the ovaries. AMH levels correspond to the number of antral follicles, which can be used to indicate the number of eggs available in the ovaries. A very low AMH level may indicate poor ovarian reserve and premature depletion of healthy eggs. A very high level of AMH may correspond to PCOS and hormonal imbalances that can cause infertility.
- FSH (follicle stimulating hormone) is a hormone produced by the pituitary gland and promotes follicle development within the ovary, thus allowing certain eggs to mature. A normal FSH level indicates that the follicles within the ovary are responding in an age appropriate manner to produce a viable egg. When the FSH is abnormal, the follicles are less responsive and the quality of the egg may be suboptimal. FSH levels can vary from month to month.
- E2 (Estradiol) is a hormone produced by the granulosa cells in the ovarian follicles. An early elevation on day 2 or 3 in estradiol levels reflects poorer egg quality and more irregular menstrual cycles. A very low level of estrogen may indicate a hormone imbalance that prevents ovulation, including menopause or hypothalamic ammenorhea.
How accurate is fertility testing?
Evaluating E2, FSH and AMH as well as taking into account a woman’s age give the best predictive model to evaluate ovarian reserve. Numerous studies support the use of these hormones to counsel women about their ovarian reserve.
How often should the Fertility Check be done?
This depends upon the patient’s age and prior results. Guidance on this topic will be provided in a conversation with a physician. However, in general, the current recommended frequency of testing ranges from 2 years for younger women with good scores, to 6 months for women with less optimal scores.
When do I have my blood drawn?
The Fertility Check is performed on Day 2 or Day 3 of your cycle. On the first day of your period (which is the first day of full flow, not spotting), you should contact our office to arrange to have your blood drawn 24 hours (Day 2) to 48 hours (Day 3) later.
How long will I have to be off the pill in order to take this test?
Contraceptive medications can interfere with the Fertility Check.
- Typically a woman on oral contraceptives (birth control pills) will get a regular period. The blood draw should be scheduled for the second or third day of bleeding. If a woman does not get a period, it should be scheduled five days after the last active pill.
- A woman that uses a patch or ring for birth control should have her blood drawn 5 days after stopping the medicine and before the patch or ring is replaced for the subsequent month.
- Women who use a hormone impregnated IUD (eg. Mirena) cannot take the Fertility Check until the device is removed and they have had at least 3 regular menstrual cycles between 27-35 days while not using the contraceptive device. If women prefer to leave the device in, they can just check an AMH level alone.
Does fertility testing tell us how good egg quality is?
The Fertility Check does not measure the quality of a patient’s eggs. The report, however, does provide information based on the most important determinants of egg quality—her age in combination with her test results. As women get older it is known that egg quality declines. Studies done on the outcome of fertility treatment for individuals with a given FSH, estrogen or AMH result and longitudinal studies looking at ovarian reserve and pregnancy rates help guide us in predicting the quality of a woman’s eggs.