For many LGBTQ moms to be, questions about how you’re going to build your family, either by yourself or with a partner, revolve around logistics. What are my options? Can my partner and I both be involved? How much is this going to cost? Will my insurance cover this? Here at Gay Parents To Be we have the team and the tools available to get you answers to those questions, but we also want you to feel empowered and in-the-know about your personal fertility.
If you have tried to conceive in the past, you may know that your own fertility can be difficult to understand. Perhaps you have been diagnosed with an hormone imbalance, such as endometriosis or PCOS, which can make it hard to wrap your head around your own fertility levels (whether you’re trying to conceive, or not!). Between cycles, treatments, hormone levels, and tests, the checklist of fertility things to know can be daunting. e’ve answered your biggest questions on what you need to know about fertility, testing, and tracking your cycle at home below.
Before we dive in, it’s important to understand the distinction between “fertility” and “infertility” - two words that are going to pop up a lot during your family building journey. Simply put, fertility is someone’s ability to reproduce. Unfortunately, the word “infertility” is where things tend to get tricky for members of the LGBTQ community.
According to the World Health Organization (WHO), infertility is defined by “the failure to achieve a clinical pregnancy after 12 months or more of regular, unprotected sexual intercourse” - aka, sperm and egg in the same environment. While this definition is outdated and doesn’t apply to many people in the LGBTQ community, it’s used in many instances as a basic for determining insurance coverage.
In the case of many same-sex couples or single moms to be, your family building involves a fertility clinic not because of “infertility,” but because you lack some of the biological necessities, and need the help of a sperm donor to conceive. If you or your partner experience one of the conditions below, that may also make your fertility journey more challenging.
Possible Causes of LGBTQ Infertility
- Polycystic Ovarian Syndrome (PCOS)
- Thyroid Conditions
- Tubal Factor Infertility
- Diminished Ovarian Reserve
- Fertility Preservation
Completing a full fertility workup and a consultation with your doctor will help you to understand your personal fertility, and build your plan for family building.
How Can I Test My Fertility?
There are two main options for fertility testing for lesbians – at-home tests and in-office testing conducted by a physician. Both options are blood tests that evaluate your hormone levels.
In-office testing may also involve numerous other tests. The three main diagnostic tests that a fertility clinic uses to determine ovarian reserve are:
(1) Cycle day three bloodwork (a blood test panel three days into your menstruation, that tests for various hormone levels including FSH)
(2) AMH (anti-mullerian hormone) - a baseline fertility evaluation
(3) An ultrasound to determine how many follicles are in each ovary (the more follicles on each ovary the better).
Additionally, you would need to get a Pap smear to detect cervical cancer, cervical problems or STDs, which can cause difficulties in getting pregnant.
Urine tests are also helpful to determine your level of LH, a hormone that increases dramatically when you’re about to ovulate. Heightened progesterone is another indicator of ovulation.
How Can I Test My Fertility at Home?
At-home testing can be an easy indicator of your fertility - thanks to technological advancement and the reliability of today’s mail services. Life is busy and complicated, so it’s important that you choose a testing option that fits with your lifestyle, budget, and schedule. It can be tough to fit in numerous doctor’s appointments when you’re juggling your work and home life.
Whether you choose a finger prick test or wish to track your ovulation with urine testing sticks, there are many at-home options to choose from.
Are At-Home Fertility Tests Accurate?
Think you want to try an at-home option, but wondering “how accurate are fertility tests?” According to multiple reviews, many at-home fertility tests are up to 99% accurate. Good news, right? But remember, these were highly accurate in a clinical setting. Once put into the hands of the average person, we need to account for human error. Making a small mistake (i.e. contaminating your sample) could skew the results, which will bring this accuracy percentage down.
While the majority of at-home tests are clinically successful, consulting a doctor is the most trusted method of determining your future fertility. If you’ve chosen to go the at-home route, congratulations! You may very well have success. If you’re struggling to get pregnant despite using these at-home tests, though, we recommend booking an appointment either with your regular OB-GYN, or a reproductive endocrinologist.
Where Can I Get an At-Home Fertility Test?
The easiest place to find an at-home fertility test is online. E-tailers like Amazon, Target, and Walmart offer an array of fertility tests, as do the sites of testing companies like Modern Fertility and Dadi.
How Can I Tell When I’m Ovulating?
Ovulation happens the moment an egg is released from an ovary. The factors below can help you determine your ovulation schedule:
- Length of your menstrual cycle - Ovulation often occurs between 10 to 16 days before the start of your period. Calculating this is fairly easy if you have a regular cycle. If your cycle is less than 21 days or more than 30, though, you should seek help from a physician.
- Body temperature - Your body temperature often rises slightly during ovulation. A thermometer and careful tracking can help you determine when this happens.
- Cervical mucus - Near ovulation, cervical mucus becomes more slippery, wetter, and clearer.
- An ovulation test - Ovulation tests can also help determine the next time you’ll ovulate. Urine stick tests, like the PREGMATE ovulation tracking kit, measure hormone levels like LH, which rise dramatically before ovulation.
The best way to track your ovulation is by using a combination of the above factors and consulting with your doctor.
Are Your At-Home Fertility Tests Not Working? Don’t Panic.
Wondering what happens when at-home fertility tests aren’t working? You’re not alone. For some people, at-home testing may not be accurate, despite trying different brands over a long period of time. Luckily, there are plenty of more reliable sources of help. Seeing a doctor is going to be the most accurate way to learn about your fertility. At a licensed fertility clinic, blood work (hormone testing) and an ultrasound (visual indicators) can determine where you are in your cycle.
However, hormones offer only a small glimpse into the whole view of your fertility, and some patients might not fully understand the results of their at-home tests. While at-home fertility tests are popular due to their convenience and price, seeing a fertility doctor offers more options to truly understand your results and, most importantly, come up with a plan to move forward.
At-Home Fertility Testing v. Testing at a Fertility Clinic
As we mentioned above, this decision can be difficult for a multitude of reasons, including test accuracy, the cost of fertility testing, and the emotional aspect of making an appointment with a “fertility doctor”. Would you feel more comfortable hearing your fertility results from a doctor in person? Or do you feel confident enough to decode the results on your own? Would you rather have a doctor help you establish a plan to monitor and manage your fertility from the start? Or, would you feel better talking with a doctor after receiving your at-home results?
Another positive to a doctor’s office visit is that, in addition to the tests mentioned above, there are other diagnostic testing options such as SHG and HSG that can help determine if there is something interfering with a positive pregnancy outcome.
Our main goal is to take the intimidation out of fertility testing so you understand all of your tools, resources available, and the steps that you can take. Whether that’s more at-home testing, a consultation with a physician, or the start to your family building journey - knowing your own personal fertility can give you the assurance you crave. Once you feel empowered with this knowledge, we’re here when you’re ready to take that next step.
Want to learn more? Check out this article on the different paths to parenthood for LGBTQ single women & same-sex female couples.