guide to treating infertility -step 3. tests
step 3. tests
seeking medical help
what are we testing for?
when evaluating a couple, a specialist is trying to determine which of the following five
essential conditions required for pregnancy may not be functioning correctly.
your doctor will check for:
- t he right balance of hormones to allow egg and sperm development and support.
- a healthy mature female egg (female oocyte or gamete) and whether ovulation regularly
takes place.
- a good quantity and quality of male sperm (male gamete).
- a functioning reproductive tract (uterus and fallopian tubes), which allows for the egg
and sperm to meet and for the egg to be fertilised.
- the ability of the female body to allow for implantation of an embryo, and to maintain and nourish that embryo
initial examination
female partner
examination of the woman includes a general physical, including a breast and pelvic examination. if you haven’t had one recently, a routine pap smear may
also be done to rule out infection or any pre-cancer or cancerous cells on the
cervix (lower part of the uterus).
male partner
the male examination may consist of a general physical and a more detailed examination of the testes, penis and scrotum. the doctor will also seek to determine the presence of a varicocele (swollen varicose vein of the spermatic cord), as this is a common infertility problem.
preliminary testing
your doctor will decide which of the following tests are the most appropriate for you.
blood tests – a series of tests will establish if there is a hormonal basis for a couple’s infertility.
these tests are also to check for:
- rubella (german measles)
- syphillis
- blood group
- hiv
ultrasound scan (also called a transvaginal ultrasound) – using a long, slender probe
inserted into the vagina, your doctor or nurse will check for the following factors:
- anything that may be affecting your cycles, such as the presence of ovarian cysts and endometriosis
- the thickness of the uterine lining and how well the uterus is responding to hormone production
- the size of your ovaries and the number of follicles present in your ovaries.
semen analysis (also called a ‘sperm count’) – semen analysis is usually performed on a
sample collected following a period of at least 36 to 72 hours without sex. it can be produced
at your clinic or doctor’s surgery or taken from home (as long as it arrives within one hour of production). the test gives a measurement of the number, movement (motility), size and
shape of the sperm, and the volume of the ejaculation. the presence of antibodies, which may cause the sperm to clump or lose their progressive motion, will also be tested. sperm
samples may be characterised as potentially fertile, sub-fertile or infertile (azoospermia).
preliminary testing – semen analysis (cont.)
the table below lists the world health organisation (who) criteria for normal semen analysis,
which may be helpful when your doctor discusses your results.
normal semen analysis who 2010 11
volume of semen ≥ 1.5 ml
sperm concentration ≥ 15 x 106 / ml
total motility (pr & np) ≥ 40%
morphological normal sperm ≥ 4%
pr: progressive motility, np: non-progressive motility
hysterosalpingogram (hsg) – this is a procedure in which a dye (‘contrast’) is injected
into the uterine cavity. x-rays are then used to visualise the uterus and fallopian tubes to
determine if any blockages are present.
a special ultrasound called a hycosy (hystero-salpingo contrast sonography) may also be arranged to check that there are no blockages in your fallopian tubes. it is used less commonly now due to improved ultrasound techniques.
laparoscopy – a small telescopic instrument is inserted through an incision in the navel to examine the areas around the woman’s uterus and fallopian tubes.
depending on your medical condition, your doctor may choose to do other procedures or tests. ask them for more information.
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