DuoFertility

Fertility Tests

Firstly, let’s be honest - the medical world does not have an explanation for everything. Infertility is a very good example of this - roughly a third of patients who are struggling to conceive are not given a medical explanation for their infertility.

Your doctor might consider getting some blood tests done in order to investigate possible reasons for a delay in pregnancy. Your doctor will base his decision on your personal medical history. Below is a list of the different types of test that your doctor might decide to perform.

Bear in mind that this list is not exhaustive.

Test for Rubella, or German measles, is an infection? that primarily affects the skin and lymph nodes. This disease is usually quite benign. However, if you are pregnant, contracting rubella may pose a risk of infection to your unborn baby and may also cause congenital rubella syndrome. If you are planning to get pregnant, it is important that you check whether you have suffered from rubella in the past. If you have never had rubella, your doctor might recommend that you get immunised against it before trying for a baby.

Test for mumps Having mumps during puberty can cause damage to the testicles. Later in life, this damage can affect sperm? production. Be sure to report any cases of mumps your partner has experienced during his lifetime to your physician. Your doctor might decide to test your blood for anaemia. He or she may also try to get an idea of your general level of fitness by counting the different cell types present in your blood.

General fitness test

Test of your hormone? levels

Testing your ovarian reserve

Your doctor might decide to test your blood in order to assess the levels of fertility-related hormones. These hormones include FSH?, LH, progesterone and thyroid hormone. The levels of FSH and LH indicate the level of your egg? reserve and the quality of your eggs, and are usually measured during the first few days of your cycle. Your doctor will also be able to check for the presence of polycystic ovaries by observing the ratio of FSH to LH.

Your doctor may also decide to check the level of prolactin in your blood which can be observed at any point in your cycle; if too much prolactin is present in your blood, it can lead to ovulatory defects. In contrast, the level of progesterone in your blood can only be measured later on in the cycle (a few days before your next period); this will allow your doctor to see whether you have ovulated and whether the yellow body (corpus luteum?) is secreting progesterone as it should. Progesterone plays a very important role in preparing the endometrium? for the implantation of the fertilised egg.

Finally, the level of thyroid hormone (TSH) in your blood can be tested at any point in your cycle; if abnormal levels of TSH are present, this can seriously affect the fertilisation of the egg. It is currently suggested that men who may have low levels of testosterone, i.e. men with a sperm concentration of less than 10 million sperm/mL, or men suffering from erectile dysfunction, should undergo a test of their hormonal level. Initially, the levels of FSH and testosterone will be assessed, and if the testosterone level proves to be low, the levels of LH and prolactin will also be assessed.

About 10% of men tested have hormonal imbalance, or endocrinopathy, but this causes infertility in only 2% of cases. Your doctor may decide to test your blood for different infections such as chlamydia, hepatitis B, hepatitis C, HIV, and syphilis.

It is quite important to test for chlamydia since the bacteria associated with this infection can cause substantial damage to the Fallopian tubes?, and therefore significantly reduce the level of female fertility. If the blood test indicates the presence of a high number of anti-chlaymdia antibodies, both you and your partner will need to be treated with a course of antibiotics.

Testing for HIV and hepatitis is especially important for couples who are planning to undergo IVF. This not only ensures that they are healthy, but also reduces the risk of the biologists and doctors working with them from being contaminated by coming into contact with the tissues or blood of the patients. In most countries, the sperm or embryos taken from a patient suffering from HIV or hepatitis are not allowed to be frozen as the storage system which is currently used cannot protect against contamination of other samples present in the storage freezer.

Ovarian reserve testing is commonly administered to women who are facing IVF, but is not otherwise normally carried out. [collapse collapsed]

Scientific references Click here to read more

Assessment of ovarian reserve--should we perform tests of ovarian reserve routinely? Hum Reprod. 2006 Nov;21(11):2729-35. Epub 2006 Aug 26.Click here to read Links Comment in: Hum Reprod. 2007 May;22(5):1492; author reply 1492-3. Assessment of ovarian reserve--should we perform tests of ovarian reserve routinely? Maheshwari A, Fowler P, Bhattacharya S. Department of Obstetrics and Gynecology, Aberdeen University, Assisted Conception? Unit, Aberdeen Maternity Hospital, Aberdeen, UK. abha.maheshwari@abdn.ac.uk Women undergoing IVF are routinely subjected to one or more tests of ovarian reserve. The results of these tests are also being extrapolated to women attending infertility clinics and those planning to delay childbearing. This debate examines the predictive power of currently available tests of ovarian reserve and questions the value of subjecting women to ovarian reserve tests. We propose that in the absence of an agreement on (i) a definition of poor ovarian reserve, (ii) the population to be tested and (iii) which interventions are effective in women with poor ovarian reserve, routine ovarian reserve testing is unhelpful. Best Pract Res Clin Obstet Gynaecol. 2006 Aug;20(4):617-36. Epub 2006 Aug 24. Endocrine evaluation of infertile men Urology. 1997 Nov;50(5):659-64.Click here to read Links Endocrine evaluation of infertile men. Sigman M, Jarow JP. Division of Urology, Brown University, Providence, RI 02905, USA. OBJECTIVES: To determine the incidence and type of endocrinologic abnormalities in men undergoing infertility evaluations and the most appropriate testing to detect them. METHODS: A retrospective review of consecutive patients attending two infertility centers was performed. Results of endocrine testing were compared to medical history and physical and laboratory findings to determine whether endocrinologic screening could be limited to a specific subpopulation. RESULTS: Only 99 of the 1035 patients (9.6%) had abnormal endocrine studies upon repetitive testing. The majority of these patients had an isolated elevation of serum follicle? stimulating hormone (FSH) levels. Only 1.7% had a clinically significant endocrinopathy that would have had an effect upon disease management. Screening with serum testosterone and FSH levels alone was just as effective as a complete hormonal panel of testosterone, FSH, luteinizing hormone?, and prolactin for the detection of clinically significant endocrinopathy. Only 1 patient with a clinically significant endocrinopathy would not have been identified if hormonal screening was limited to only those patients with a sperm density of less than 10 x 10(6)/mL. CONCLUSIONS: Endocrinopathies are a rare cause of male infertility. Endocrine screening of men with sperm counts of less than 10 million/mL with serum testosterone and FSH levels alone will detect the vast majority of clinically significant endocrinopathies.