Your First Step: Fertility Testing

When you decide to pursue fertility treatment, the first thing you will have to decide is which practice you want to go to, and which fertility doctor you want to see. How do you know who will give you the best chance of a successful pregnancy and healthy baby?

Modern fertility treatments rely significantly on science to determine your cause of infertility and the best way to treat it. That makes the fertility doctors at any practice very important. You want them to have in-depth diagnostic experience, a thirst for new knowledge, and compassion for their patients. 

A board-certified Reproductive Endocrinologist has received the highest level of training in reproductive medicine. This position requires medical residency and examination in obstetrics and gynecology, followed by another three years of training in reproductive endocrinology and infertility, and additional oral and written examinations.

If you are diagnosed with the following conditions, a board-certified Reproductive Endocrinologist is the best option for treatment:

• Polycystic ovarian syndrome (PCOS)
• Endometriosis
• Hypothalamic pituitary dysfunction
• A congenital adrenal hyperplasia
• Tubal factor infertility
• Male factor infertility
• Diminished ovarian reserve
• Fertility preservation
• Congenital uterine anomalies

Don’t be embarrassed to ask questions about your doctor’s background and experience. Any physician can call themselves a fertility specialist. It doesn’t mean they have met the standards to provide the best treatment and guidance. Learn more about the differences here.

The answer depends on your health insurance plan and whether the state you live in mandates fertility coverage, among other factors. At Illume Fertility, we assign each patient their own Insurance & Billing Advocate to help you navigate your insurance coverage. However, the following questions are a great place to start when speaking to your insurer:

• Criteria that need to be met before accessing coverage
• Are there diagnostic or testing requirements?
• Is IUI required before IVF? Will coverage include treatment for ovulation induction? Use of donor eggs or sperm? Surrogacy?
• What, if any, deductible must be met before reimbursement kicks in?
• Which state’s laws apply to your employer’s insurance contract? If you work in Connecticut, it may be a New York policy, for example.
• Make sure you understand how the company defines “unlimited.” It may mean that the treatment is deemed medically necessary, and you may need your medical team to advocate for you.
• Maximums
  • What is the maximum lifetime amount that will be covered?
  • Are medications included in the lifetime max?

• Deductibles

• Is there a pharmacy deductible?

• What medical services go toward meeting deductibles?

• How do out-of-network services affect the deductible?

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 6 months of unprotected, well-timed intercourse. And for women 40 and older, the wait is three months. However, if you are a member of the LGBTQ+ community, meeting the requirements for an “infertility” diagnosis gets much more complicated (and we agree - these archaic definitions need to be updated).   

Comprehensive fertility testing for both partners (if applicable) can help you maximize your chance of achieving success in the shortest time possible.

At Illume Fertility, your first appointment will be with your Reproductive Endocrinologist, who will discuss your history and your partner’s history (if applicable) and how long you’ve been trying to conceive. Your doctor will discuss which diagnostic testing they recommend.

When you schedule your first appointment, one of our New Patient Liaisons will thoroughly explain everything you need to know about or submit ahead of time. Your first appointment will typically be a virtual consultation. Learn more about how to prepare for your first big appointment here.

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

When hormone testing is concluded and analyzed, physical testing may begin, including:

• Basal Antral Follicle Count
• Hysterosalpingography (HSG)
• Sonohysterogram (SHG)
• Transvaginal ultrasound