If you and your partner are trying to have a baby, you may be wondering if you should get a fertility test or pre-pregnancy screening done. But while the two are easily confused for the other, they are for significantly different purposes. A pre-pregnancy test is highly encouraged for couples who are planning to get pregnant, while fertility screenings are for couples who have been trying to get pregnant for a period of time without any success. There is no single best test for infertility – doctors use a variety of ways to identify the unique problems that might cause a couple’s fertility issues. In this article, we discuss the common uses and processes of fertility screenings and pre-pregnancy tests and their differences.
What is a fertility screening?
To get pregnant, your uterus, fallopian tubes, and ovaries first need to be working well. Via a fertility screening, your doctor will be able to help decipher if you have any fertility problems. Fertility screenings comprise a myriad of tests and questions that help identify any potential abnormalities, dysfunctions, and conditions that could get in the way of conception and a healthy pregnancy. Here are some examples of the questions your doctor might ask:
| Questions about |
Examples |
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You and your partner |
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Your sex life |
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Your menstrual cycle |
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What does a fertility screening for women involve?
Here are a few common fertility tests you’ll undergo:
|
Fertility test |
What it entails |
| Pap smear | Used to detect abnormal cells around the cervix, a pap smear can detect cervical cancer1 and other pregnancy-intefering problems, such as an STI. |
| Ovulation test | Your doctor might conduct an ovulation test to check if you’re releasing an egg every month. |
| Hormone test | Your doctor may check the level of progesterone in your blood. Progesterone is a hormone that indicates ovulation. You might also be asked to take a home urine test for luteinizing hormones (LH), which is present in high levels just before ovulation2. Your doctor may also run tests on your thyroid, or check for other hormonal problems, to rule out conditions that might cause dysfunctional ovulation. |
| Blood test | You may get a blood test to check your levels of follicle-stimulating hormone (FSH), which triggers your ovaries to prepare an egg for release each month. High FSH levels can signify lower fertility in women. Your doctor may suggest a blood test to check your anti-müllerian hormone (AMH) levels. AMH levels can give an idea of how well your ovaries function. Low levels of AMH can suggest low ovarian reserve and lesser ovary function. |
| Hysterosalpingogram (HSG) | Also called a tubogram, an HSG is a series of X-rays of your fallopian tubes and uterus. One method involves the injection of liquid dye through the vagina and X-rays, while another method utilises saline, air, and ultrasound. A HSG will allow your doctor to check if your fallopian tubes are blocked, or if you have any problems with your uterus. This test is usually done right after your menses. |
| Transvaginal ultrasound | A doctor inserts an ultrasound wand into the vagina to inspect your pelvic organs. By utilising sound waves, they’ll be able to help identify any potential issues with your ovaries and uterus. |
| Hysteroscopy | Your doctor puts a thin, flexible tube with a camera through your cervix and into the uterus. This will allow your doctor to detect potential problems and take tissue samples if need be. |
| Laparoscopy | Your doctor makes small cuts in your belly and inserts a camera to check your entire pelvis and potentially correct problems, such as endometriosis, which can severely hinder your chances of getting pregnant. |
What is a pre-pregnancy check-up?
A preconception checkup is a medical checkup done before pregnancy to ensure parents are healthy when they get pregnant. At your pre-pregnancy checkup, your doctor will look out for health conditions that may affect your chances of a healthy pregnancy. Even if you’ve already had a baby, a pre-pregnancy check-up is still highly encouraged, as your health might have changed since your last pregnancy. What is a pre-pregnancy check-up? A preconception checkup is a medical checkup done before pregnancy to ensure parents are healthy when they get pregnant. At your pre-pregnancy checkup, your doctor will look out for health conditions that may affect your chances of a healthy pregnancy. Even if you’ve already had a baby, a pre-pregnancy check-up is still highly encouraged, as your health might have changed since your last pregnancy. What does a pre-pregnancy check-up involve?
- At your pre-pregnancy screening, your doctor will:
- Check your overall health
- Help detect any underlying conditions
- Note you and your partner’s family health histories
- Talk to you about when to stop using birth control
- Answer your questions about pregnancy
Here are a few key tests that you’ll likely undergo for a pre-pregnancy screening in Singapore:
|
Pre-pregnancy test |
What it entails |
|
Pelvic exam |
This is an exam of your pelvic organs, which includes the vagina, cervix, uterus and ovaries. Getting treatment for any dysfunctions before pregnancy can help prevent unwanted complications and infertility problems. |
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Physical exam |
This will help check your overall health, covering areas such as your blood pressure, weight, and preexisting conditions like diabetes and STIs (eg. genital herpes, HIV). |
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Pap smear |
As mentioned above, a pap smear will help detect any abnormalities within your cervix that could prevent you from having a healthy pregnancy. |
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Blood test |
Blood tests help check your blood type and Rh factor, a protein found in your red blood cells. If your Rh factor is negative and your baby’s Rh factor is positive, problems could occur. This is known as Rh incompatibility4. |
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Preimplantation genetic testing (PGD) |
If you or your partner is a carrier of certain genetic conditions, and you’re having in-vitro fertilisation (IVF), PGD helps check the embryo for any gene changes before they’re implanted in your uterus. After PGD, only healthy embryos are implanted. |
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Pre-pregnancy carrier screening |
These blood or saliva test checks will help check if you or your partner might be a carrier of certain genetic conditions that could affect your baby (eg. cystic fibrosis, sickle cell disease). If both of you are carriers of the same condition, the risk of your baby being born with the condition increases. Getting tested before pregnancy can help you and your partner make better, well-informed decisions. |
Pre-pregnancy vs. fertility tests: Which is suitable for me?
Pre-pregnancy testing is highly encouraged for couples looking to get pregnant, and is of even higher significance if:
- Certain genetic health conditions run in your family
- You have medical conditions like diabetes or high blood pressure
- Have had past pregnancy issues (eg. premature birth, miscarriage, stillbirth)
- Have a smoking, drinking, or drug habit
Following a pre-pregnancy test, your doctor can help you manage any health conditions and guide you and your partner when it comes to making the necessary lifestyle changes for a healthy pregnancy and baby. If you and your partner have been trying for more than a year, or more than six months (for those aged 35 and above), a fertility screening could help you identify problem areas, pinpoint the treatment you need, and help build the family you hope for.