Get Clear Answers With Fertility Testing

If you’re under 35, most doctors recommend testing after 12 months of trying. At 35 or older, that recommendation drops to 6 months. If you’re over 40, talk with a fertility specialist about evaluation right away.

You may also want to test sooner with irregular cycles, known reproductive or genetic conditions, recurrent pregnancy loss, male fertility concerns, or if you're planning egg freezing, donor conception, or another path that doesn't start with trying to conceive on your own.

Most testing is well tolerated, and blood work and ultrasound are routine for the vast majority of patients. HSG and saline sonography may cause brief cramping.

During an HSG, contrast dye flows through the uterus and fallopian tubes. During a saline sonogram, sterile saline expands the uterine cavity so it can be examined by ultrasound. If your Care Team says ibuprofen is safe for you, taking it beforehand can help. Discomfort usually passes within a few minutes after the procedure ends.

If you have a history of pelvic pain, sexual trauma, or find procedures like these anxiety-inducing, please tell your Care Team beforehand so they can walk you through exactly what to expect and ensure you feel as comfortable as possible throughout.

A fertility workup commonly evaluates hormone levels, ovulation, ovarian reserve, the uterus, fallopian tubes, and sperm health when applicable. Your evaluation may also include an HSG or saline sonogram based on your history and treatment plan.

Genetic carrier screening may be recommended as well.

Your doctor will customize your diagnostic plan to your history, age, and family-building goals.

Most patients complete a full fertility workup within one menstrual cycle, roughly four to six weeks from the first appointment to your results review.

Some tests, like Day 3 bloodwork, have to be performed during a specific window early in the menstrual cycle, which is why timing matters more than how quickly you move through the process.

If you’ve been trying to conceive and a standard infertility evaluation finds no clear cause, the diagnosis may be referred to as unexplained infertility. Up to 30% of couples experiencing infertility receive this diagnosis after a standard evaluation.

Your doctor may recommend continuing to try on your own for a period of time, IUI with ovarian stimulation, or IVF based on your age, timeline, and goals.

Need a little hope? Read success stories from other Illume families who have overcome unexplained infertility with the help of fertility treatment.

Source: ASRM

Coverage depends on your health insurance plan and whether your state mandates fertility coverage, among other factors.

Connecticut and New York both have fertility insurance mandates, but the specifics vary by employer and plan. At Illume Fertility, every patient is assigned a financial coordinator to help verify your benefits and understand your policy before testing begins.

We encourage you to call your insurance carrier or speak with your HR department for additional clarity. These questions are a good starting point:

• Are there diagnostic or testing requirements before treatment is covered?
• Is IUI required before IVF, and does coverage extend to ovulation induction, donor eggs or sperm, or surrogacy?
• What deductible must be met before the plan begins sharing costs?
• Which state's laws govern my employer's insurance contract? If you work in Connecticut, your policy may still be governed by New York law, for example.
• What does the plan mean by 'unlimited,' and does it require your medical team to document medical necessity?
• Is there a maximum lifetime benefit, and are medications counted toward it?
• Is there a separate pharmacy deductible, and how do out-of-network services affect what you owe?

Learn more about affording fertility testing and treatment by exploring our Finance Hub.

On October 15, 2023, the American Society for Reproductive Medicine (ASRM) Practice Committee issued a new definition of infertility.

Infertility is a disease, condition, or status characterized by any of the following:

• The inability to achieve a successful pregnancy based on a patient’s medical, sexual, and reproductive history, age, physical findings, diagnostic testing, or any combination of those factors.
• The need for medical intervention, including, but not limited to, the use of donor gametes or donor embryos in order to achieve a successful pregnancy either as an individual or with a partner.
• In patients having regular, unprotected intercourse and without any known etiology for either partner suggestive of impaired reproductive ability, evaluation should be initiated at 12 months when the female partner is under 35 years of age and at six months when the female partner is 35 years of age or older. 

Most importantly, ASRM adds, "Nothing in this definition shall be used to deny or delay treatment to any individual, regardless of relationship status or sexual orientation."

Fertility testing is often an integral part of LGBTQ+ family building. It can help guide donor selection, reciprocal IVF planning, decisions about which partner carries the pregnancy, and treatment timing.

Anyone who produces sperm, including transgender women and some nonbinary patients, may need a semen analysis regardless of gender identity.

Testing can often be adapted for patients assigned female at birth who do not currently menstruate. The recommended tests and timing depend on anatomy, hormone use, medical history, and family-building goals.

Some fertility test results remain current for about six months, but there is no universal expiration date. Retesting windows vary by test, treatment plan, insurance requirements, and clinical history. Your Care Team will confirm which results need updating.

If you complete testing and aren't ready to start treatment right away, your doctor will let you know closer to the six-month mark whether anything needs to be repeated before you move forward.

Tip: If you’ve already met your insurance deductible, completing covered testing before the plan year resets can lower what you pay for those tests. Confirm coverage, timing, and retesting requirements with your insurance carrier and Illume financial coordinator before scheduling.