Fertility Evaluation & Management - Male & Female:
The first step in addressing infertility is making an accurate diagnosis, not jumping straight to treatment.
There are multi-fold causes of infertility that vary. This may involve male, female, or both types of factors.
Women's fertility relies on the production of healthy eggs by the ovaries. The reproductive tract must be open to allow an egg to pass into the fallopian tubes and merge with sperm. Then the fertilized egg must travel to the uterus and attach itself to its lining. Tests for female infertility focus on the detection of a malfunction in any of these processes.
Hormonal tests for female:
AMH blood test which measures ovarian reserve hormone. This is a very good estimate of the number of eggs you have in your ovaries.
FSH and LH are the other values of hormones indicating quality and quantity of eggs that could be produced during each cycle
Levels of TSH to rule out thyroid issues
Levels of prolactin often found raised in failed conception cases.
Sexually Transmitted diseases test like HIV, HbsAg, HCV, VDRL.
Ultrasound scan
An ultrasound scan lets us to survey:
Ovaries filled with cyst, Antral follicular count, presence of polyps and fibroids, investigate the status of endometrium, presence of number of follicles and size of the ovaries, any kind of other anomalies.
Extra advanced Tests:
1. Sonohysterogram - this test helps in checking of uterine cavity and tubes. This is non-invasive test.
HysteroSalpingoGram – checking of the fallopian tubes if they are open or blocked through X-ray procedures.
2. Hysteroscopy- extremely important test with failed IUIs, and must before going on to IVF procedure.
3. Endometrial biopsy, which is the removal of a bit of tissue from the lining of the uterus, also called the endometrium.
4. Diagnostic laparoscopy is hardly performed, as it is the most invasive type of fertility test. This test is only done when symptoms are seen for endometriosis or unexplained infertility.
Male Fertility Test
The most important fertility test carried out on a man is semen testing. Through semen analysis, fertility status can be checked. The sample of semen taken from the man is processed in a laboratory and analyzed.
- DNA Fragmentation: Less than 10 percent clinics take the DNA fragmentation test but gaining momentum as the gold standard tests for sperm viability. DNA fragmentation allows identification of the sperms which may have good chances of fertility, embryo growth, chance of implantation, miscarriage, or any abnormalities in the child.
- Sonography: Ultrasound or sonography may be performed to evaluate the seminal vesicles and scrotum. A physical examination by a urologist or Fertility Specialist must be conducted if he has any history of physical or childhood trauma.
- Hormonal Tests: Men may have hormonal imbalances that impact the production of semen. Common tests include serum FSH and testosterone levels, and sometimes LH, estradiol, or prolactin.
- Infectious: STD testing will have to be done to ensure that there is no infectious status.
Our expert opinion
Fertility testing can be quite complex and distressing. Please meet our experts and learn a lot about these tests. This way, you will feel much more at ease and the process would become tolerable for you that helps you to conceive.
Some causes of infertility cannot be treated.
If pregnancy does not occur within a year of unprotected sex, though, many couples are still able to conceive through forms of infertility treatment known as assisted reproductive technology. But treatment requires big financial, physical, emotional, and time commitments.
Assisted reproductive technology (ART) is any type of fertility treatment that involves handling the egg(s) and sperm. The most common type of ART is in vitro fertilisation, or IVF.
Some of the followings are steps in an IVF cycle:
Medically known as ovulation induction, fertility medications stimulate the ovaries to produce eggs. The eggs are collected from the ovaries and matured in the lab. Eggs are fertilised with sperm in a dish in the lab.
The fertilised eggs, also known as embryos, are placed in the uterus. Embryos can also be frozen for future use.
In some cases, during an IVF cycle, other techniques are used, such as:
Intracytoplasmic sperm injection (ICSI): A mature healthy egg has a single sperm injected directly into it. Often, ICSI is employed when semen quality and or quantity is low. Alternatively, it may be used if attempts to fertilize in previous IVF cycles have been unsuccessful.
Assisted hatching. This procedure makes implantation of an embryo easier into the uterine lining. It is established to open part of the outer casing of the embryo, therefore, the name hatching.
Donor eggs or sperm: Most of the time, couples undergo ART through the usage of one's own eggs and sperm. However, you have the right to utilize eggs or sperm from a donor. This applies in cases where you are single or in a same-sex relationship. Moreover, it is also carried out for medical purposes. Such include poor quality of the egg resulting from old age and abnormality in sperm such as blockage within the reproductive system. Donor eggs or even donated sperm may be employed if either one of the partners has a genetic disorder that can be transmitted to a baby. Infertile couples can also utilize donated embryos. Others are from couples who have had fertility treatment and have remaining embryos that are frozen.