What You Need to Know About Fertility Testing: The Honest Truth

from someone who's gone through it

I’m not great at facing things until they’re about to steamroll me, so I hadn’t done any research into fertility testing until I was faced with my own fertility challenges. My OB-GYN was wonderful and fully described every single test, but I was still caught off-guard every time. I heard the words, “There will be some pain and discomfort” and didn’t necessarily process it would feel like something hot and sharp poking my spine.

The tests were also emotionally difficult. I had a miscarriage a year before I started fertility testing and some muscle memories flooded open. Beyond that, though, I also hadn’t fully appreciated how invasive the procedures all were.

When I was in high school, my friends and I dissected every second of someone’s first kiss so that the rest of us could better prepare for when it was our time. Fertility testing never really made the list of important topics so I’d never even had a proper conversation about it. I reached out to and spoke with Lilli Dash Zimmerman, MD, Fertility Specialist at Columbia University Fertility Center to get a better understanding of how to think about the testing and what to expect. Here were my top takeaways from our conversation.


1. Reframing helped me reduce resentment

I was mostly frustrated throughout the testing process about how my husband got off pretty scot-free. He had to give a semen sample once, from the privacy of our own home. I had numerous blood draws (which took me straight back to blood tests post-miscarriage for HCG levels), several invasive procedures requiring catheters placed in my cervix, and constantly peeing on a stick.


Source: @alainakaz


When I spoke to Dr. Zimmerman, she helped me reset my framework. Part of the reason why uterus testing is so much more in-depth has to do with looking at two different aspects of pregnancy: hormonal and structural. They test to see if your hormones are performing correctly, since those are what make your body release the egg, but they are also looking at the structure of your uterus, fallopian tubes, and more. Sperm only has one job to do, whereas the uterus has 10 months worth of growing and changing to do.


Sperm only has one job to do, whereas the uterus has 10 months worth of growing and changing to do.


As simple as it sounds, this helped me feel a lot better about the testing I had already experienced. Testing brought up a lot of emotions for me, and part of that was frustration toward the medical system and my husband because his part was so much easier. But understanding why we needed each of the different types of images reminded me that the ultimate goal is to get as much information as possible to be able to make a more accurate diagnosis. It hasn’t been easy to stop resenting my husband, so I try to remember that he’s been ready with the chocolate (and support) when I get done with every procedure.


2. Knowledge is empowering (and can help mitigate pain and frustration)

Part of why it was so difficult to understand that pain and discomfort (i.e., that stabbing pain in my spine) is because I only heard the words, but I experienced the pain. There is your brain’s memory, and then your body’s memory. The more information I had in both areas, the more prepared I felt. Dr. Zimmerman walked me through each and every fertility test for uteri. This clarified expectations for me.

Once I had some testing under my belt, I also knew my body’s response to certain procedures. Because I knew that catheter insertion is excruciatingly painful for me, I worked on some yoga exercises to relax my pelvis before the second test, mitigating some of the pain. That information was vital for me to have an easier time. So pay attention to your body as you go through the testing to see how you can ease your pain.


Because I knew that catheter insertion is excruciatingly painful for me, I worked on some yoga exercises to relax my pelvis before the second test, mitigating some of the pain.


Also, testing involves way more moving parts than I initially realized: like scheduling a time in the radiology department or testing at a certain part of your cycle. So, for example, if the wrong part of your cycle fell on a long weekend when labs are closed, you have to wait until your next cycle. I had to get comfortable with it taking a few more months than I had initially anticipated and through no fault of my own.



3. Unexplained infertility doesn’t need to stop you

So this was a big one that I wish I had fully understood going into testing. I was looking forward to the end of testing, to be given my marching orders on exactly how to “undo” my fertility challenges. I figured once we had a diagnosis, there would be specific solutions and my love of following instructions would get us through the next part.

Turns out, 1 in 5 couples will experience something called unexplained infertility. Once I learned we likely fell under that category, I got even more frustrated. How do you combat something that is unexplainable?

Talking to Dr. Zimmerman, though, she said the reason they label it that way is because there isn’t a one-size-fits-all solution for this diagnosis. Your doctor will tailor the plan to you and what your factors are—age might be a factor, family history might be a factor, you might be more sensitive to certain medications. So while it is technically unexplainable, it doesn’t mean that there aren’t very clear, active steps you can take to help create higher odds of conceiving.



Fertility testing is a rough process no matter what. Nobody starting a family is hoping to have fertility challenges, so it already comes with emotional baggage. Then there is further anxiety as you wait for each set of results to come in. The next steps might be murky and give no sense of relief. If you are doing any of it, all of it, none of it, you are incredible. Prepare yourself as much as you can and just take it one test at a time. And know that you can do as much or as little of it as you want to and whatever you decide will be what is right for you.