Why Imaging and Blood Tests Aren’t the Gold Standard for Diagnosing Fertility Problems

If you’ve been struggling to get pregnant and have visited a fertility doctor to try to figure out why, it’s likely that you’ve been subjected to about a million diagnostic tests. If that’s the case, it may surprise you to learn that I believe these types of tests are NOT the gold standard for diagnosing fertility problems.

The truth is, most of the diagnostic tests performed by fertility specialists can only spot blatant hormonal imbalances or physical blockages, which is one of the reasons so many couples are labeled with “unexplained infertility”. And even if you’re lucky enough to receive a diagnosis for your fertility problem, the testing will reveal nothing about why your suffering from an imbalance in the first place. Then regardless of the problem, as a first step on the slow march toward IVF, you’ll likely be prescribed one or more of a long list fertility drugs with scary side effects and told to hope for the best.

There are several reasons I believe these tests aren’t the best way to uncover and solve the issues at the root of your fertility problems. One is that they typically only test for imbalances of the so-called sex hormones, like estrogen, follicle stimulating hormone (FSH), luteinizing hormone (LH), etc. While testing for these hormones can provide some insight, they are far from your complete hormonal picture.

The female endocrine system is incredibly complex and the organs, glands and hormones that make up what is traditionally though of as the entirety of your reproductive system are just one small part of the story. There are a full complement of other hormones that can affect your fertility in subtle and not so subtle ways, including cortisol, insulin, thyroid hormones, and others. The role these hormones play when it comes to a woman’s fertility are often overlooked, but can impact your ability to conceive in a major way when they’re out of balance.

Another reason these tests miss so many subtle problems is the way the results are interpreted. Reference ranges (the so-called “normal range”) for lab values are based on the average numbers obtained from testing a wide swath of the population. Large numbers of lab tests are obtained and normal is consider the range into which 95% of the population fall.

The first problem with this approach is that what is normal for 95% of the population may not be normal for you. You may be one of the 5% whose normal falls outside of the reference range. And even if your normal falls within the reference range, the range for any given lab test is typically pretty wide. It’s quite likely that the normal range for your body is actually much more narrow. That means that if you fall at the low end of the reference range, but normal for your specific physiology would be higher, you may test “within range”, but still be out of balance. For example, the mid-cycle reference range for FSH (follicle-stimulating hormone) is 4.0-25.0 mIU/mL. If a test reveals that your level is 7.4 mIU/mL, your levels will be considered “normal”, even though the optimal level for you would actually be 18.0-23.0 mIU/mL. These common types of imbalances are called “subclinical”, meaning that a problem exists, but isn’t obvious from looking at lab results.

The second problem is that just because 95% of the population falls within a specific range, it doesn’t mean that those numbers are truly normal. For example, if everyone tested has been exposed to chemicals in the environment that disrupt hormonal levels (pesticides for example, or BPA which is still found in many plastics), the numbers that are considered normal wouldn’t necessarily be optimal. While many people may be able to conceive without problem even when their hormone levels have been slightly affected by these chemicals, others won’t be so lucky. If your body is more sensitive to environmental chemicals than others, even a small variation from optimal may be enough to prevent you from getting pregnant.

Finally, it’s possible to develop hormone resistance when your body is overloaded with certain hormones over time. The most well-known example of this is insulin resistance, in which cells stop responding to insulin’s hormonal signals when blood sugar remains elevated over time, eventually culminating in the development of type II diabetes. Though lesser-known, this type of resistance can occur with other hormones as well, such as insulin, thyroid, and cortisol. In these cases, you may test normal or even slightly high for certain a hormone, but because your cells are unable to respond to these hormonal messengers you may be exhibiting symptoms of imbalance.

So if diagnostic testing can be unreliable, what’s the best way to determine an imbalance?

In my practice I rely on two main diagnostic tools: a symptom assessment and basal body temperature (BBT) charting. As a practitioner of Chinese medicine, I was trained to assess subtle imbalances and look for patterns in symptoms that may be missed by Western physicians.

Even if you’ve never received a diagnosis for your fertility issues, your body holds many clues to the imbalances that are preventing you from becoming pregnant. Seemingly inconsequential symptoms like having chilly hands and feet, getting mild headaches, or even being prone to worrying too much might be overlooked by most western doctors, but from a Chinese medical perspective these minor issues can hold the key to uncovering the imbalances that are preventing you from becoming pregnant.

Once we determine the underlying reason you’re having trouble conceiving, we can restore your body to balance by addressing the root cause of your fertility issues.

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