Fertility testing involves both partners. While most of us think of pregnancy as happening in the woman's body, conception takes two. Infertility diagnosis is performed initially, by collecting complete medical history and physical examination. It is then followed by diagnostic tests for infertility.
When to do a fertility test?
If a couple does not get pregnant after a year of trying (or after six months of trying when the female partner is older than 35), both the man and woman should go for fertility testing. People who suspect they may have a problem with infertility due to family history of infertility, abnormality of reproductive organs, or experiencing other conditions that can affect fertility, may want to seek testing earlier.
The infertility evaluation is based on each individual’s condition and health history. Some patients might need to undergo all the tests to diagnose the cause of infertility, while others may only need a few. The gynecologist will recommend what tests are best for each patient on a case-by-case basis.
Fertility Testing for Women
Firstly, a detailed history of pregnancy, menstrual cycle, general health is assessed.
- A basic hormonal workup that includes FSH, Prolactin, Free T3, Free T4, and TSH is usually done in either D2 or D3 preferably in the morning with an empty stomach.
- Ovarian Reserve (AMH Test) measures the level of AMH hormone to help estimate the number of eggs, especially when there is a risk of decreased ovarian reserve (ex: advanced maternal age/ history of previous ovarian surgery/ history of cancer chemotherapy or pelvic radiation). We come across many patients with impending ovarian failure even in their early 30s.
- A pelvic scan is needed to rule out any pathology in fibroids, adenomyosis, etc., and to diagnose polycystic ovaries and hydrosalpinx. Antral follicle count measured during scan done on D2 of cycles can give useful information regarding the ovarian egg reserve and also decide the type of ovarian stimulation needed.
- Hysterosalpingogram (X-ray with a dye) is done definitely before going for IVD. It can give a clear picture of whether the tube is patent or damaged leading which into fluid collection within it (Hydrosalpinx). If the ultrasound suggests a possible blockage, your doctor will refer you to a specialist for further checks.
Fertility Testing for Men
The workup for both partners will be complete only after doing the basic workup like hemoglobin, blood sugar, renal function test, screening tests like HIV, and routine analysis for the male partner. In addition to the basic workup, a semen analysis is done. If it turns out to be abnormal, then hormonal workup like FSH, LH, TSH, Prolactin, and testosterone are done. You may need a scrotal Scan- Doppler to confirm the clinically diagnosed varicocele. In case of a long duration of infertility or previous failed attempts without any identifiable cause, we need to go ahead with the sperm DNA fragmentation test which can shoe the genetic integrity of sperm, the factor that cannot be diagnosed in routine semen analysis.
- Semen Analysis is to check for problems with sperm such as the number of sperm present and any abnormalities in the shape (morphology) and movement (motility) of the sperm. The semen is checked for infections as well.
- Male hormones, including testosterone, are vital for sperm production and sexual development, so a blood test is commonly conducted to examine hormone levels.
- STD testing
- Scrotal ultrasound tests for testicle obstruction. A trans-rectal ultrasound closely looks at the vesicles and ejaculatory ducts that transfer semen.
Explore Your Treatment Options
Cause(s) of infertility can be diagnosed through an extensive and comprehensive infertility workup on both partners. Once fertility testing is complete, you'll meet with the gynecologist or reproductive endocrinologist to discuss
- What the results mean
- What further testing, if any, is needed
- What treatment would be appropriate
- Decide the next course of action
With the correct diagnosis, your chances of becoming pregnant increase significantly. If you are looking for the best fertility specialists in Chennai, visit your nearest PFRC branch. Consult with the top Fertility Experts in India.