Infertility Investigations

It is important to carry out investigations on both partners. One-third of infertility will be due to female factors, one-third due to male factors and one third due to factors in both partners.

Female Testing

The following female investigations are available:

BMI
Height and weight are used to calculate body mass index (BMI – kg/m2). There is a strong correlation between BMI and infertility.

Egg Reserve
Egg reserve is assessed by measuring the levels of the combination of AMH (anti-mullerian hormone) and FSH (follicle stimulating hormone).

Routine Blood Tests
Your specialist will arrange a panel of blood tests at your first appointment to check your hormones, full blood count, blood group, immunity to chicken pox and rubella, and an infection screen for hepatitis B and C, HIV and Syphilis.

Ovulation Test
Testing progesterone seven days after ovulation is the routine way to confirm ovulation has occurred. This is done on day 21 in a 28 day cycle. Sometimes more detailed cycle tracking is required with a series of blood tests and an ultrasound scan.

Sexually transmitted infections
A urine sample will be taken to test for the two most common sexually transmitted infections that cause damage to the fallopian tubes, namely gonorrhoea and chlamydia.

Hysteroscopy and Laparoscopy
Your specialist will recommend either a hysteroscopy alone or a combination of both a hysteroscopy and laparoscopy, if they suspect that you may have a structural problem with the pelvis that surgery could improve. This includes surgery for polyps, fibroids and endometriosis. Surgery is often initially for diagnosis, but treatment can usually be completed during the same procedure.

Testing fallopian tube latency and confirming a normal uterine cavity
Structural defects of the uterus and blockages in the fallopian tubes can be confirmed using an ultrasound called a HyCoSy (Hystero Contrast Sonography). Alternatively, the pelvis can be more accurately assessed surgically with a hysteroscopy and/or laparoscopy.

Genetic Testing
A karyotype test determines whether you have normal chromosomes. One percent of people have a chromosomal translocation, where parts of different chromosomes are switched. This can cause reduced fertility, miscarriages or a handicap.

Unscreened couples also have a one in 500 chance of having a baby with a handicap due to a single gene defect. You will be offered an optional couple screening test, before starting treatment, for the most common recessive and X-linked conditions that fall into this category of genetic disease. The Beacon expanded carrier screen, by Sonic Genetics, tests for 400+ single-gene defects. If both partners carry the same autosomal recessive condition, such as cystic fibrosis, there is a one in four chance of an affected child. If the screening determines a high risk of a certain genetic condition, IVF with pre-implantation genetic testing (PGT) can be performed to reduce the risk of having an affected child.

Male Testing

The following male investigations are available:

BMI
Height and weight are used to calculate body mass index (BMI – kg/m2). There is a strong correlation between BMI and infertility.

Sexually transmitted infections
A urine sample will be taken to test for the two most common sexually transmitted infections that cause damage to the male genital tract, namely gonorrhoea and chlamydia.

Genetic Testing
A karyotype test determines whether you have normal chromosomes. One percent of people have a chromosomal translocation which can cause reduced fertility, miscarriages or a handicap.

Unscreened couples have a one in 500 chance of having a baby with a handicap due to a single gene defect. You will be offered an optional couple screen, before starting treatment, for the most common recessive and X-linked conditions that fall into this category of genetic disease. The Beacon expanded carrier screen by Sonic Genetics tests for 400+ single gene defects. If both partners carry the same autosomal recessive condition, such as cystic fibrosis, there is a one in four chance of an affected child. If the screening determines a high risk of a certain genetic condition, IVF with pre-implantation genetic testing (PGT) can be performed to reduce the risk of having an affected child.

Routine Blood Tests
Your specialist will arrange a panel of blood tests at your first appointment for an infection screen for hepatitis B and C, HIV and Syphilis.

Sperm Testing
There are three assessments that are generally performed on a semen sample. The first assessment is a semen analysis that tests the concentration, motility and morphology of the sperm.

A second assessment is an anti-sperm antibody test that looks for the presence of antibodies bound to the sperm that affects their function. In particular, they inhibit sperm from binding to an egg.

Finally, a sperm DNA fragmentation test assesses oxidation damage to the sperm and is thought of as a measure of sperm quality. High rates of DNA fragmentation are associated with poor embryo development, increased rates of miscarriage and possibly increased rates of some abnormalities in babies born.

For more information, please email the Minerva Fertility IVF Nurses at nurse@minervafertility.com.au or call us on +61 2 8883 3319