Infertility Tests & Diagnosis | Male & Female

The success of every IVF treatment in Vashi depends on an accurate diagnosis of the infertility factors. Both in the male and female. At Thanawala’s Maternity home & IVF Center we put special emphasis on accurately diagnosis the infertility factors in the couple. This helps us in prescribing an IVF treatment protocol with the best chance of conceiving a baby, in the 1st cycle itself.

Medical History:

The IVF specialist needs to know a detailed medical history of both to couples. To check if any medical condition or surgery, that they have or had in the past, might be the reason for infertility.

Diagnostic Tests to identify Female infertility factors

1. 1. IVF Diagnostic Test to examine the Uterus & Ovaries: The health of the uterus and ovaries is checked using an ultrasound machine. This is done to examine if any major anomaly is causing infertility. These Anomalies might be fibroids in the uterus, abnormal shape of the uterus, etc. The ovaries are examined to check volume and overall health of the ovaries.
   2. IVF Diagnostic Test to examine the Ovarian Tubes/ Fallopian tubes
      Ovarian Tubes/ Fallopian tubes are generally tested for patients who have a past history of major medical conditions like TB, cancer, endometriosis or if the patient has undergone abdominal or uterine surgeries. It may also be recommended to patients who had a failed IUI cycle, even though they did not have any past medical history.  In such cases, the fallopian tubes might get blocked preventing the sperm from reaching the egg or preventing the egg from reaching the uterus. Since, this blockage cannot be examined via ultra-sonography, a specialised test like HSG or a laparoscopy is requried.
      1. Hysterosalpingogram (HSG): HSG is an imaging test done to identify blockage of the fallopian tube. It is done at an X-ray centre. During an HSG an iodine contrast is introduced into the uterus and is pushed up to the fallopian tube. The X-ray of the pelvis is taken which clearly highlights any anomaly, if present in the fallopian tubes. This test is rather painful & not very specific. Hence, we recommend a laparoscopy instead.
      2. Laparoscopy: Laparoscopy is relatively painless as it is done under general anaesthesia. A laparoscope is inserted into the uterus and in the abdomen – for a direct visualization & fallopian tubes to check for any blockages. If any blockage is found the same can be opened in the same sitting using the Hysteroscope. The patient can go home the same day.
   3. AMH or Ovarian Reserve Test: It is blood test which can be done at anytime. The AMH helps us assess the quality and quantity of eggs that are remaining in a female. The AMH gives the IVF specialist an assessment of how the patient will respond to the IVF stimulation during an IUI or IVF cycle.
      1. The ideal AMH value for fertility varies between 2.2ng/ml to 4.4ng/ml (nanograms per milliliter).
      2. An AMH value of 0.3ng/ml – 2.2ng/ml is considered low fertility. While a value of 0.02ng/ml – 0.3ng/ml is considered very low and might indicate that eggs are not present.
      3. An AMH level greater than 6.8ng/ml is considered very high. High AMH is generally seen in women with PCOD. These women can be very sensitive to IVF stimulation. Hence, require very specific dosage.
   4. Routine Blood Tests: routine blood tests are required to check the overall health of the women. Of particular importance are the blood sugar and thyroid levels which can adversely affect the treatment process.
      a. Blood Sugars: Monitoring the blood sugar is very important especially for diabetic. If the women’s sugar is very high during pregnancy the baby can have birth defects. Also, during egg retrieval a prick is made, if the sugars are high the chances of infection increases. Hence, she might need sugar control before starting an IVF cycle.
      b. Thyroid test: If the thyroid is high the patients might not respond to the IVF treatment as it directly affects the ovaries sometimes.

Diagnostic Tests to identify Male infertility factors:

1. Semen Analysis: In this analysis, semen is collected from the male. The semen is put into special processing  chambers called makler counting chamber. This chamber provides the count, motility (Movement) and health of the sperm.
2. Sperm Count: A semen count of 20 million /mL or more is considered good.
3. Motility: Makler counting chamber analyses and rates motility of the sperms on a scale of 0 to 4. A score of 0 means sperm is less motile. While a score of 3 or 4 indicates that the sperm is has good motility.

Factors to be considered if there is a low sperm count –

1. Identifying Bad Habits: Its necessary to know if the male is has addiction or if he consume excessive amount of alcohol or cigarettes. Alcohol and smoking are known to reduce sperm formation.
2. Diagnosing Past Medical History that may cause infertility:  The IVF specialist would asses if any abdominal surgeries like hernia or any scrotal injury which are known to affect sperm production.
3. Undescended testes or Cryptorchidism: Sperm production in the testis is a very temperature sensitive process even 2-3 degree of temperature increase can destroy any sperm that may be produced. The abdominal temperature is much higher that the scrotal temperature. This eventually leads to low sperm production. Consequently, affecting the sperms ability to impregnate the egg.