Fertility Tests

I previously shared that we finally had some sort of fertility update. In June 2022 we started working with an NaPro doctor. These doctors take a more holistic approach to fertility. That’s not to say they don’t use modern medicine because they definitely do! They just look at more aspects than other doctors. In the beginning of the process they warn you it will be overwhelming. There are a few reasons for this but the main reason is that there is so much testing to be done and it needs done at specific times during your cycle making it even more difficult. It’s important to note our journey isn’t the same as yours but I’m hoping this might provide someone with some guidance or some answers to move forward. This is the extensive list of fertility tests that we have had done as part of our experience with NaPro.

First Round

The first round of fertility tests have to be done on days 3-5 of your cycle. Thankfully for me, I was on day 3 when I had my call so I was able to go for the testing the very next day. However, if you are in the middle of the cycle this could be put off for you and might not actually be your first round but rather your 2nd or 3rd because of where it falls. Mine just happened to be fall perfectly in line with my cycle so that we could follow the entire thing. Which is actually really convenient but also sort of overwhelming to have the first call and then have to take immediate action. Anyways, here are the fertility tests they did and why they did them for this round.

• Prolactin: In the beginning of your cycle you want prolactin to be low. Prolactin is what will prohibit your body from secreting FSH (which is what causes you to ovulate). If it’s high in the beginning of your cycle it may indicate that you are not ovulating.
• Testosterone(Free, Bioavailable, and Total): High testosterone can indicate PCOS
• DHEA: This one I’m not an expert on. From my understanding DHEA is an indicator of your testosterone/estrogen balance. Low DHEA can indicate low ovarian reserve and can prevent ovulation.
• Cortisol: Indicates your stress levels. High levels are associated with miscarriage and infertility.
• Vitamin D: Low vitamin D levels can be associated with PCOS, endometriosis, uterine fibroids.
• T3 Reverse (thyroid): Reverse T3 is an inactive ‘thyroid hormone’, if no other tests indicate a thyroid issue this one may be the cause. It’s not very often tested because the other tests generally will diagnose if there is a thyroid issue.
• T3 Free, T3 Total, & T4 Free- These tests will indicate if you have hypo- or hyper- thyroid. Even if your TSH is normal these may be out of range and thus indicate a problem. Always push for more than just TSH.
• Androstenedione- High androgens can be one of the tests that will indicate PCOS.
• ThyroglobulIn Antibody- Positive TPO  (thyroglobulin antibodies) is most commonly associated with an increased risk of developing hypothyroidism.
• Thyroid Stimulating Hormone- TSH, can indicate hypo or hyper thyroid issues. 
• Thyroglobulin Peroxidase Antibody- Indicates the autoimmune disorder, Hashimoto’s.
• MTHFR- A controversial gene that only certain doctors will test. From my understanding the biggest impact to fertility is that it can cause blood clots.
• Blood Glucose/Insulin- This is that 3 hour one that pregnant ladies have to go through but they also test insulin on top of glucose. Insulin resistance can cause low glucose readings but will still show there is an issue. It’s a really long test with 5 pokes overall.

My First Round Results

The results were the easiest part! They came through my online portal and I could see right away if they fell outside of the range. My doctor also sends messages to me on certain ones too if there is immediate action to be taken. The results of my fertility tests:

• Prolactin- Normal
• Testosterone- Normal
• DHEA- Normal
• Cortisol- Normal
• Vitamin D- Normal
• T3 Reverse- Low
• T3 Free- Normal
• T3 Total- Normal
• T4 Free- Normal
• Androstenedione- Normal
• ThyroglobulIn Antibody- Normal
• Thyroid Stimulating Hormone- Within the “normal” range but on the high side and much higher than what is ideal for fertility.
• Thyroglobulin Peroxidase Antibody- High
• MTHFR- Don’t have results yet
• Blood Glucose/Insulin- Mostly normal, one low reading

Second Round Fertility Tests

The second round of fertility tests to be done are the progesterone and estradiol. After ovulation your estrogen should go down and your progesterone should go up. This round needs done approx. 7 days after you ovulate. It’s so important that you are tracking your cycle before working with these doctors. Mine isn’t particular on how I test but they do ask a lot of questions about where you are at and what your symptoms are like during different phases so it is super helpful. Based on where I’m at in my cycle right now we can’t test these quite yet.

The symptoms that I’ve described to my doctor leads her to believe that I have low progesterone. The biggest symptom, that I had no idea was important, was sleep. Right around ovulation and then after I have interrupted sleep. It’s very frustrating and I didn’t think much of it until I started documenting it and noticing it was only at certain times. As soon as she heard this my doctor immediately suspected this was an issue. If it is, I will go on progesterone immediately after ovulation each month and then continue it through the entire first trimester if pregnancy occurs.

The Last Round

The last round, for us, is testing for two infections that can occur. They are really long names and I’m still waiting to have them done. That means, I don’t have the results yet to be able to share them with you. However, what I do know is that anyone can have these infections. They have absolutely zero symptoms but do impact fertility. If I am positive my husband and I will need to do a round of antibiotics before trying to get pregnant again.

Tests We Already Had

Thankfully, we were slightly ahead of the game although what got us here is still really sad for us. My husband already had a sperm analysis that came back completely normal. If he hadn’t had that test we would need to get that done. We may even need to get this retested at some point but for right now they are okay with the results. The other test that they would have done if I hadn’t already had it is a hysterosalpingogram. This test consists of injecting dye into the uterus. The dye will show if there is an abnormality in shape or blockages in the fallopian tubes. Mine came back completely normal although it was, at one time, suspected that I had a heart shaped uterus. 

In Summary: Fertility Tests

So far, my fertility tests have indicated a thyroid issue. The antibodies in my blood show that I have an autoimmune disorder called Hashimoto’s disease. I started thyroid medication days after finding out this diagnosis. At the in person appointment where they test for the infections my doctor will go over all of the results cumulatively and tell me if there are any correlations that indicate any further issues. I’m both nervous and excited but we are finally getting some answers and hoping that they lead to a baby on this side of heaven.

What testing have you done for fertility? What answers have you found? Are there any that you would add to this list?