If you have been trying to conceive for over a year and consult a specialist, your clinician will arrange for you both to undergo a series of tests. Whilst infertility affects both men and women equally, if you have consulted a fertility specialist, you have been trying for 6 months or more and the female partner is over 35, your doctor may recommend investigations immediately. The primary reason for this is that female fertility declines with age and being older than 35 may reduce the chances of natural conception. Early diagnosis and treatment can optimise success.
When you get referred for further investigation, there are a number of different tests you could be asked to undergo by your GP or fertility specialist, and it is natural to have questions. We’re here to help answer some of those questions.
Female tests
Blood tests:
What happens?
- A small sample of your blood is collected for testing in a short and virtually painless procedure. If you are having periods, this sample may be taken early in your cycle (for FSH and LH) or on day 21 of your cycle (for Progesterone).
What are they testing for?
- These are used to test a number of things, but mainly different hormone levels. Day 21 (mid-luteal phase) Progesterone levels are checked to see if you are ovulating. FSH and LH levels are responsible for developing a follicle within which an egg grows. These hormone levels can help establish what issues might be responsible for a lack of ovulation or irregular/absent periods. An AMH test is a good indicator of ovarian reserve to give some indication of whether you are able to produce enough eggs.
- A raised testosterone level is often seen in women with Polycystic Ovarian Syndrome (PCOS)
Ultrasound scan
What happens?
- This depends on the type of scan you are going for. An external ultrasound scan of your ovaries and reproductive organs would be exactly like ones which are used to examine a pregnant lady. Some gel will be rubbed on your lower stomach and the probe scans the area. If you are going for a transvaginal ultrasound, then a very small probe will be inserted into your vagina to scan. Ultrasound scans can be enhanced with a kind of contrast media using a technique called HyCoSy. This makes visualisation of the anatomy of the reproductive tract easier and clearer.
What are they testing for?
- Your doctor will be checking your reproductive organs and looking for any potential issues. This includes cysts, endometriosis or damage to your fallopian tubes. Transvaginal ultrasound scans are usually more focused on your ovaries and fallopian tubes, testing to see if you have a blockage or anomalies.
Male tests:
Physical examination/check-up
What happens?
- Your genitals will be examined by your doctor who will also ask you a number of questions regarding your medical history
What are they testing for?
- Genital exams can help identify a number of issues, which could be affecting your fertility. This includes whether or not you have a varicocele which is a common issue for sub-fertile men. A varicocele is when the veins, in this case within the scrotum, enlarge and this can cause overheating which in turn can cause oxidative stress and harm sperm production. The questions on your medical history can help make the clinic aware of any conditions, injuries, surgery, or health problems which could affect fertility.
Semen analysis
What happens?
You’ll be asked to go to a clinic and give a sperm sample.
What are they testing for?
- Most sperm tests will check for the basic sperm health parameters. This would be sperm count (number of sperm per ml), morphology (size and shape) and motility (ability to swim in a straight line). All three of these factors are important when considering male fertility. However, often overlooked is the DNA fragmentation test. This tests for the quality of the DNA within the sperm, which is vital for conception. If you are having a semen analysis, it would be a good idea to also have a sperm DNA fragmentation test as well, although this may not be readily available on the NHS.
Men and women: Chlamydia test
It is important that both partners are tested for Chlamydia
What happens?
- You will usually be asked to give a urine sample, but could have a small swab sample from your genitalia
What are they testing for?
- Chlamydia is a sexually transmitted infection (STI) which can negatively affect fertility. If you test positive for this infection, you’ll be prescribed medication to help treat it.
- This is especially important in the female partner, as chlamydia infections can cause pelvic inflammatory disease and damage to the female reproductive tract, including fallopian tube damage.
Results
Your clinician will usually give you a rough idea for when you can expect your results. A lot of conditions are manageable and can be treated with medication, which your doctor will prescribe to you if necessary. Others can be solved with small routine surgical procedures.
Overall fertility can be improved by making small lifestyle changes and supplementing your diet. If you are struggling with irregular periods and anovulation, then you could be diagnosed with PCOS. Inofolic Alpha could help.
If your sperm test includes DNA analysis and you are told you suffer from DNA fragmentation, Impryl has been proven to help. Impryl has also been shown to increase AMH levels in women, which is a good indicator of improved ovarian function.
There are hundreds of testimonials for both Impryl and Inofolic Alpha where you can see how the products have managed to help so many other couples who have been struggling to conceive.
