Recommended tests to help choosing a fertility treatment

If it has been about a year since you began trying to become pregnant, or if you know, because of your personal situation, now is the time to begin treatment, your Fertility professionals will need to run tests to choose the treatment that best suits your circumstances.

Fertility professionals can go far beyond analysing each partner’s individual case. They also analyse family history as well as environmental factors, work conditions or personal habits that can affect fertility.

If there is no clear cause of a reduced fertility, they will begin by doing the basic tests. For women, apart from having the appropriate gynaecology examination (with cervical smear or mammogram, if relevant), they will request a series of specific tests:

• Transvaginal ultrasound: Ultrasound scan that provides extremely valuable information about the morphology of the uterus and ovaries, and enables a look at ovarian and endometrial response throughout the ovarian cycle. It also gives information about your ovarian reserve.
• Anti-Müllerian hormone (AMH): A blood test can measure AMH levels, enabling the Fertility professionals to assess your ovarian reserve at any point during her cycle.
• Other hormone tests: An important part of the Fertility Test is to measure the hormone levels in the blood for the hormones responsible for a woman’s regular ovarian cycle. The following hormones are usually measured by taking a blood test: FSH, oestradiol, LH, progesterone, prolactin and TSH.
• Karyotyping: This can reveal any chromosomal anomalies that would explain diminished fertility. It can be done through a blood test.
• Serology tests: This blood test is essential, even though it doesn’t give any information about the reproduction process. It looks for signs of current or previous exposure to certain infectious diseases by determining which antibodies you have produced.

If, on the other hand, a blockage in the fallopian tubes is suspected, or your Fertility professionals simply wish to rule that out, it is recommended doing:

• Hysterosalpingography (HSG): This is an x-ray using a contrast medium (fluid) which is injected through the neck of the uterus, allowing the Fertility professionals to examine the uterine cavity and condition of the fallopian tubes. A blockage in both tubes will prevent both natural fertilisation and artificial insemination. This test is taken after your period has finished but before ovulation.

If you are hoping to use your partner’s semen, a semen analysis and REM test should be taken to confirm the quality and survival of the sperm and to make an estimate of how it will perform during In Vitro Fertilisation. They will also need to have serology tests to rule out any infectious diseases.

If you have already undergone several treatments without becoming pregnant, a genetic sperm test may be recommended. A FISH and DNA fragmentation test will enable your Fertility professionals to assess his DNA chains to check if there are any problems with these which is preventing embryos from being fertilised or from developing.

These tests are the most common, but it will be your doctor who recommends the tests that will allow them to develop a suitable treatment plan specifically tailored to you.