Fertility Test

Introduction

The fertility tests are done to evaluate the potential of women to bear a child and of men to beget a child. These tests are a very important part of work-up for treatment of infertile couples. Before undergoing these tests, the couple must be aware that a certain amount of commitment is required. Your doctor usually determines what the sexual habits of the couple are and may make recommendations about how to change any unhealthy habits. The tests may extend over several months. In about one-third of infertile couples, no specific cause is found (unexplained infertility).

However, it should be kept in mind that the evaluation is expensive and in some cases involves uncomfortable procedures. Also, there is no guarantee of conception even after all the testing and counseling.

Tests for men

For a man to be fertile, puberty should occur at right age, the testicles must produce enough healthy sperm, and the sperm must be ejaculated effectively into the woman’s vagina by intercourse. Tests for male infertility attempt to determine whether any of these processes are not in order.

• General physical examination. This includes examination of the genitals and the doctor asks questions concerning the previous medical history, illnesses and disabilities, medications, and sexual habits.

• Semen analysis. This is a very important preliminary test for the male partner. The doctor may ask for one or more semen specimens. Semen can be obtained by masturbation or by interrupting the ongoing intercourse and ejaculating the semen into a clean container. A laboratory analyzes the semen for quantity, color, and presence of infections or blood.

• Anti-Sperm Antibodies. Some men make abnormal antibodies against their own sperm. The antibodies attack the sperm on the way to the egg and thus prevent fertilization.

• Hormonal testing. A blood test is done to determine the level of male sex hormone testosterone and other male hormones.

• Transrectal and scrotal ultrasound. Ultrasound can help the doctor to look for evidence of conditions such as retrograde ejaculation and obstruction in the ejaculatory duct.

Tests for women

For a woman to be fertile, the ovaries must release healthy eggs regularly, and her reproductive tract must allow the eggs and sperm to pass into her fallopian tubes to become fertilized by a sperm. Her reproductive organs must be healthy and functional.

Firstly, the doctor asks questions to the woman regarding the medical history, menstrual cycle and sexual habits. A general physical examination is done. This also includes a careful gynecological examination. Specific fertility tests may include:

• Ovulation testing. A blood test is sometimes performed to measure hormone levels to determine whether the woman is ovulating.

• Hysterosalpingography. This test evaluates the condition of the uterus and fallopian tubes. Radio-opaque fluid is injected into the uterus. X-ray pictures are taken to determine if the anatomy of uterine cavity is normal and also ensure the fluid progresses through the fallopian tubes. Blockages or other problems often can be located and may be corrected with surgery.

• Laparoscopy. This is performed under general anesthesia. It involves making a small incision (8 to 10 millimeters) beneath the navel and inserting a thin, telescopic camera through it to examine the fallopian tubes, ovaries and uterus.

• The most common problems diagnosed by laparoscopy are endometriosis and scarring. The doctor can also detect blockages or irregularities in the lumen of fallopian tubes and uterus. Therapeutic measures can also be taken by laparoscopy to address these problems. Laparoscopy generally is done on an outpatient basis.

• Hormone testing. Hormone tests may be done to check the blood levels of ovulatory hormones as well as thyroid and pituitary hormones.

• Ovarian reserve testing. This is a special test which can help to determine the potential effectiveness of the eggs after ovulation. This approach usually begins with hormone testing in the early menstrual cycle of the woman.

• Genetic testing. Genetic testing and counseling may be done to determine whether there is any genetic defect causing infertility.

• Pelvic ultrasound. Pelvic ultrasound is very useful to look for uterine or fallopian tube disease.

Every patient does not need to undergo all, or even many, of these tests before the cause of infertility is found. The sequence and type of tests depend on discussion and agreement between the woman and the doctor.