Investigating Infertility – Preliminary Tests

As part of the assessment for assisted reproductive techniques (ART), you are required to undergo a number of routine investigations and procedures. Your fertility specialist will do an initial assessment of your general health and previous history and advise you of the tests/investigations required as part of the work-up prior to commencing your treatment.

Your tests may include some or all of the following:

Blood tests (Men and Women)

  • Rubella
  • HIV
  • Blood Group
  • Hormone Levels
  • Hepatitis B & C
  • Sperm Antibodies

1. Rubella

Female patients are tested for Rubella (German Measles) immunity. If there is no natural immunity to Rubella, then vaccination must be undertaken before commencing treatment. This eliminates the potential danger of the effects of Rubella with early pregnancy.

2. Hormone levels

Estrogen, Progesterone, Prolactin and Follicle Stimulating Hormone levels are generally tested in the first week of your cycle prior to treatment to ensure that these are normal.

3. Sperm antibodies

Some blood from the female partner can be used to add to the fluid in which the eggs are grown, to act as a source of nutrients. Occasionally, this may contain antibodies to the partner’s sperm which will prevent fertilisation. If the blood is sperm antibody positive, it is discarded and a donor’s blood, or another source of nutrients, is used.

4. HIV

This is now the internationally accepted way of classifying the AIDS virus and stands for Human Immunodeficiency Virus. There are three reasons for performing this test, although the risk of exposure to this virus is very low. The first reason is the risk of a pregnancy to a female who is infected with the virus. Pregnancy increases the death rate dramatically in an HIV positive woman. The second is the risk of transmitting the HIV virus to a child during childbirth. The third is the risk to IVF staff who are handling body fluids from a large population on a daily basis. Special precautions would be required for samples from HIV positive patients.

This test may be emotive for many patients, but it is considered an important part of routine investigation processes for both partners.

5. Hepatitis B and C

Hepatitis has similar risks to HIV. Hepatitis is more infectious than HIV, although the death rate is much lower. Both partners should be tested.

6. CA-125

This blood test is a marker for endometriosis. It is a chemical which circulates in the blood if a patient has endometriosis or other ovarian problems.

Baseline Ultrasound Scans (Women)

A vaginal ultrasound is required. The reasons for the ultrasound are to:

  • Determine if there are any physical changes, such as fibroids or polyps, that may effect your cycle, and also check for the presence of ovarian cysts;
  • Assess the ease of ‘access’ to your ovaries, as your eggs will be collected using an ultrasound-guided method;
  • Provide a ‘baseline’ report that can be used as a reference during your treatment cycle; and;
  • Measure the size of your ovaries and count the number of small follicles present in your ovaries.

Occasionally you may need other baseline scans done prior to treatment cycles. Most women find a vaginal ultrasound to be a relatively painless and simple procedure. The woman’s partner or a support person can be present during the procedure if she wishes. An empty bladder is required for this procedure.

Semen analysis (Men)

Two semen analyses are required. At least one semen analysis should be performed prior to treatment. These analyses may include tests for sperm antibodies in the semen and checks for possible infection that may affect fertilisation. Details on collection of the sample will be given to you when you make your appointment. Your GP might have already sent you for a semen analysis as part of your initial investigations, but it is important that this test is repeated at the IVF laboratory as test results can vary between laboratories and also over time.

Semen production

Providing a semen sample on the day of egg collection can be quite embarrassing and stressful. We endeavour to make this event as easy as possible for you.

Firstly, it is important to remember that the personnel who will be dealing with you and your sample are doing their normal day’s work and, although it may not seem so to you, find it quite commonplace.

Secondly, there are alternatives to producing your sample at the Clinic. The sample may be produced off the premises and brought to the Clinic in the appropriate sterile container (as long as the time to travel is within one hour and you are not classified as male factor).

The sample does not need to be produced by masturbation. Your partner may accompany you and special condoms can be provided to collect your sample.

Often when men are anxious and having difficulty producing a sample, a couple of hours break (i.e. walk or a movie) may help. Please inform our staff, so that they can adjust their laboratory schedule.

Some IVF clinics have the capacity to freeze your sperm. It could be used as a back-up if you have difficulty producing on the day of your partner’s egg collection. It should be noted that sperm freezing may reduce the motility of your sperm.



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