Getting Started with Fertility Testing

What is infertility and how is it diagnosed?

The short answer is that infertility is a medical condition.

As described by Resolve: The National Infertility Association, infertility is a disease or condition of the reproductive system often diagnosed after a couple has had one year of unprotected, well-timed intercourse, or if the woman has suffered from multiple miscarriages and the woman is under 35 years of age. If the woman is over 35 years old, it is diagnosed after six months of unprotected, well-timed intercourse. And for women 40 and older, the suggested wait time before seeing a doctor is only three months.

As the American Society of Reproductive Medicine says, infertility is NOT an inconvenience; it is a disease of the reproductive system that impairs the body's ability to perform the basic function of reproduction.

Comprehensive fertility testing (for both men and women) can help you maximize your chance of achieving success in the shortest time necessary. The rest of this guide is designed to provide all the information you need when you decide to begin the process of fertility testing.

Do You Need Fertility Treatment?

According to the Centers for Disease Control, some level of infertility affects one in eight couples. 35% of men and 35% of women are affected by infertility, meaning men are just as likely to be infertile as women.

While there are many causes of infertility, about 30% is “unexplained” or “idiopathic.” That label doesn’t mean you can’t be treated. As with any other diagnoses, it leads to decisions about treatment individualized for you, most likely involving intrauterine insemination and in-vitro insemination.

The key point to remember is this: You have many fertility treatment options that can increase your chances of having a baby.

Steps to Take When Experiencing Infertility

If you are comfortable trying home options and treatments that are considered non-traditional, you have options. Certain herbs are promoted as useful for fertility. At the same time, many may be harmful and should be avoided. It’s best to consult this list with your doctor before experimenting.

Acupuncture is a safe treatment for many types of pain (remember that if you become pregnant) and according to recent studies, can enhance embryo implantation rates by up to 15%. As is often the case with acupuncture, the science behind the treatment hasn’t been settled, and perhaps the experience of relaxing in a calm environment for 30 minutes at a time is as conducive to fertility as the acupuncture itself.

Insurance Plans Can Differ from State to State

Connecticut law requires most insurance companies to cover infertility diagnosis and treatment, including up to four cycles of ovulation induction, a maximum of three intrauterine insemination (IUI) cycles, and up to two in vitro fertilization (IVF) treatments. The Connecticut State Mandate requirements do not apply to employees in self-funded insured plans or to employees who work for certain religious groups.

New York requires private health insurance plans to cover the diagnosis and treatment of infertility for patients between the ages of 21 and 44 who have been covered under the policy for at least 12 months. However, several procedures, including IVF, are excluded.

Laws in 13 other states -- Arkansas, California, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, Ohio, Rhode Island, Texas, and West Virginia -- require insurance companies to cover or offer coverage for infertility diagnosis and treatment.

Some companies self-fund their insurance, which means they don’t have to follow state mandates on fertility coverage. You may be able to purchase a rider to the insurance policy that will pay for some or all fertility treatment expenses not covered in your plan, whether it is self-funded or not.

The best thing you can do is to learn how to work with your insurance carrier. The relationship doesn’t need to be adversarial, but patients sometimes need to be persistent before they receive answers that are accurate to their specific situations. Call your insurance representative as often as you need to when you have questions. Don’t forget to check your bills to make sure they are correct.

In Connecticut, you can exhaust coverage on a policy, and then switch policies to gain additional coverage. Your new carrier cannot claim a “look back” under previous policies in order to exclude procedures.

If you work for a company that doesn’t offer health insurance, perhaps it’s time to find a family-friendly employer. More firms are realizing the value of supporting the needs of their workers and offer wide coverage at reasonable costs.

When you have health coverage, educate yourself about your rights. In Connecticut, state law requires most insurance companies to cover infertility diagnosis and treatment, including up to four cycles of ovulation induction, a maximum of three intrauterine insemination (IUI) cycles, and up to two in vitro fertilization (IVF) treatments. The Connecticut State Mandate requirements do not apply to employees in self-funded insured plans or to employees who work for certain religious groups.

New York requires private group health insurance plans that are issued or delivered in the state, and that provide coverage for hospital care or surgical and medical care, also must cover the diagnosis and treatment of infertility for patients. They must be between the ages of 21 and 44 and have been covered under the policy for at least 12 months. The New York law excludes certain procedures, including IVF and vasectomy reversal, although a new bill has been introduced that may change the coverage.

Fertility Testing for Women

Much of the initial testing for women involves examinations of hormone levels. Blood tests, such as AMH (anti mulerian hormone) can easily detect a hormone imbalance that prevents a pregnancy from occurring or continuing.

These three hormones can all be checked with a simple performed on Cycle Day 3. Normal value ranges for the FSH, LH and E2 tests may vary among different laboratories, so it's important to get an accurate interpretation of the results from your fertility specialist.

Fertility Treatment Cost

Financing offered through Illume Fertility

Illume Fertility wants to make it possible for any couple or individual to receive the fertility treatments that they need, no matter what their financial status. We work to eliminate obstacles, allowing patients to budget wisely, avoid cash flow problems and hold on to your savings or investments. There are no pre-payment penalties, hidden fees, or down payment requirements. And payment plans are individually tailored with low fixed or variable interest rates.

At your first visit to an Illume Fertility office, an Insurance & Billing Advocate will review your treatment plan and explain the various options to make family building affordable, even without employer insurance.

If you are not ready to start a family immediately, the Egg Freezing Opportunity Plan allows you to plan for the future without letting financial concerns get in the way.

We work with a third party lending company, The Lending Club, to offer loans and lines of credit offering a variety of terms to fit your financial profile.

Government rules also allow people to save money, in many cases with taxes deferred, to pay for health costs, including infertility treatment.

Fertility Testing For Men

Men particularly can feel isolated as they don’t often speak to their friends about their infertility experiences. They also typically concentrate on how the women in their lives are managing fertility treatment and ignore their own feelings or struggles.

There are many reasons why couples have trouble achieving pregnancy. Male infertility accounts for up to 40% of the difficulties. Male fertility hinges on having healthy sperm, so semen analysis is the most important test for the male half of a couple that is experiencing fertility issues. It is an inexpensive test that should be done early in any infertility evaluation.

A semen analysis is one of the tests your doctor will use to evaluate your problem. Your test results will tell your doctor the number of sperm in your semen (your sperm count), whether they are normal (morphology), and how well they swim (motility). A low sperm count may be caused by certain medications or a medical problem such as a blocked duct, low testosterone level, or a condition in which sperm back up into the bladder. Fever can also reduce sperm count. Some men may have enough sperm, but their sperm may not swim well enough to reach the egg. Also, sperm that are not normal in shape may not be able to penetrate and fertilize the egg. Your doctor can treat many of these problems.

Your Infertility Diagnosis: What You Should Expect

After the infertility testing is done, your doctor will discuss the results with you and explain treatment. Often the most frustrating diagnosis is “unexplained.” As explained at Resolve.org, “some diseases and medical conditions defy explanation. They just happen. The term ‘unexplained infertility’ really reflects the present limitations of medical science. The fact is that current technology does not have the tools for revealing the cause of your infertility.”

Even with the frustrating diagnosis, you will have options. Your doctor will prescribe individualized treatment for you and your situation.