One out of six couples experiences some form of subfertility. Specialized fertility centers with testing and treatment protocols have been instituted to provide assistance especially for these couples.
Fertility testing is the mainstay of identifying various fertility issues and their underlying causes. It comprises medical interviews, biochemical tests, imaging studies such as ultrasound scanning and operative procedures such as laparoscopy.
Fertility tests are divided into two main categories, viz. male fertility test and female fertility test.
What is a male fertility test?
The male fertility test is the laboratory analysis of a semen sample to examine the quality and quantity of sperms. The sample is analyzed in order to determine the average volume of semen, its viscosity, and the number of sperm.
Qualitative analysis a key part of the male fertility test. It detects how many normal or motile sperms are present in the sample compared to the number of abnormal sperms. While it’s normal to have a tiny amount of abnormal sperms in the sample, increased numbers of abnormal sperms constitute a major problem with respect to male infertility.
Apart from semen analysis, a detailed interview and genital organ examination are done to ensure there are no visible or palpable anomalies that could be causing infertility. Ultrasound scanning is also performed as part of the fertility test to image the testicles and its surrounding structures.
What is the female fertility test?
Fertility tests for women are conducted to identify the causes of subfertility and infertility among females. As the probable causes of female subfertility are vast in number, female fertility tests are directed at multiple systems involved in the reproduction process.
A detailed interview is performed by the fertility expert followed by an abdominal and pelvic examination. Subsequently, an ultrasound scan is performed in order to exclude any structural causes of infertility.
What is an ovulation test?
An ovulation test is performed to determine exactly when a woman ovulates. This is a ‘do-it-yourself’ urine analysis test that measures the luteinizing hormone surge in the body, a phenomenon which coincides with ovulation. The test is done during the week when the woman suspects she might be ovulating; a chart is maintained accordingly with the LH levels. Both sperm and ova can only survive unfertilized for a limited amount of time, therefore, synchronizing the period of ovulation with sexual intercourse can lead to favorable results. Ovulation test kits can be bought over the counter at pharmacy stores.
Ovarian reserve test
The developing follicles in the ovary secrete a hormone known as antimullerian. The amount thus secreted is proportional to the number of follicles remaining in the body. The ovarian reserve test is a blood test carried out to determine the levels of antimullerian hormone in the body. Low values indicate a fewer number of follicles.
Ovarian function tests
Ovarian function tests examine the functions and levels of reproductive hormones during the menstrual cycle. The Day 3 FSH (measuring follicle stimulating hormone), Day 3 estrogen (measuring estrogen), ultrasound (to confirm ovulation occurred) and blood levels of Inhibin B are included in this series of tests.
Levels of hormones that affect the reproductive system are assessed in this procedure. They include,
- Luteinizing hormone
- Follicle stimulating hormone
- Thyroid hormones
- Total testosterone and free testosterone
When an identifiable cause cannot be detected through biochemical and imaging studies, the fertility specialist performs the following tests.
Hysterosalpingogram (HSG): A special X-ray performed by introducing a dye into the uterus and fallopian tubules to check for obstructions in the tubes.
Hysteroscopy: Direct visualization of the uterus using a special camera known as the hysteroscope which is introduced through the vagina. An endometrial biopsy is also performed to detect structural abnormalities in the endometrial tissues.
Laparoscopy: Performed in order to detect conditions such as endometriosis, the procedure involves making small incisions in the abdomen through which a camera is introduced. Laparoscopy is both diagnostic and therapeutic as conditions like endometriosis can be treated and ovarian drilling be performed to stimulate the ovaries.