A number of couples will seek help with fertility and require fertility tests to understand the cause of infertility relevant to their circumstances. Almost one in six couples will seek help with delays in conceiving, but only a small proportion of these require fertility treatment. There are many causes of infertility, and in some couples more than one factor may be involved. A third of the couples may experience delays in getting pregnant due to female factor, whereas in another third, it could be male factor. In the remaining, there is no identifiable cause and is referred to as unexplained infertility. There are also growing number of couples, who seek these tests to give themselves a peace of mind and space in terms of planning family. Here we explain few common tests for men, women and couples. You can contact us for more information about any test that you are interested in and not listed here.
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Female Fertility Tests
There are various causes of female infertility, such as irregular ovulation, damaged or blocked fallopian tubes or implantation dysfunction. There are a range of tests that give us information about ovarian reserve or egg health, tubal block, hormonal dysfunction or imbalance, malformations of womb or a range of genetic conditions. We offer all fertility tests including wellness checks or MOT.
London IVF and Genetics Centre offers a detailed fertility MOT and testing assessment programme to assess your ovarian reserves. At our London fertility clinic, we are sensitive to the very common anxiety of lowering ovarian reserves or the faster ageing of eggs.
Antimullerian hormone or AMH
Antimullerian hormone or AMH is a hormone produced by very small follicles that form part of pool of follicles within ovaries. The levels of this hormone can be measured by a simple blood test and gives us an idea about ovarian reserves or egg health. A low AMH level suggests declining ovarian reserve because of early aging of ovaries. It may affect quality of your oocytes and hence, your chances of conceiving naturally or following treatment. We offer this test on its own or as part of fertility wellness check or MOT.
Follicle stimulating Hormone or FSH
Follicle Stimulating Hormone or FSH is a hormone produced from a small gland in brain called pituitary gland. FSH regulates the development of follicles within ovaries and plays a key role in ovulation. A high FSH level suggests low ovarian reserve and may affect your fertility. The levels fluctuate during the menstrual cycle. Hence, it is important that this blood test is timed correctly to reliably measure ovarian reserve.
Hormonal imbalance
There are many hormones that are produced by various endocrine glands. They play a crucial role in ensuring normal follicular development and regular ovulation. Sometimes, there may be disruption in the functioning of these glands resulting in hormonal imbalance. Some of the common examples of such conditions are polycystic ovarian syndrome or PCOS, hypothyroidism (underactive thyroid), hyperthyroidism (overactive thyroid), hyperprolactinaemia (high prolactin level) or hypopituitarism. These are only a few examples and there are many other endocrine disorders that may affect fertility. Most of these hormones can be measured by a blood test, but some require more specialised tests. These can be treated by medications and may improve your chances of conceiving naturally as well as following fertility treatment.
Ovarian Reserve Test
Ovarian reserve test includes AMH, FSH and antral follicle count. By using a combination of parameters, the predictive value of the information obtained is better when compared to single tests. A reduced ovarian reserve is sign of early ovarian aging and may affect your chances of conceiving naturally or after fertility treatment.
HyCoSy or Hystero-Contrast Sonography
This is a special pelvic ultrasound scan that gives us information about fallopian tubes. There are many causes that may result in blocked tubes, such as infection, pelvic inflammatory disease or past surgery. A blocked tube will prevent fertilisation by preventing movement of sperm from the womb to the ovary. It is a minor procedure that is quite similar to smear test. A fine tube or catheter is placed into womb and a special dye is instilled. The spillage of dye from the tubes is seen on an ultrasound scan. Failure to see clear spillage on one or both sides may be suggestive of blocked fallopian tube.
HSG or Hystero-salpingogram
This is also a test to check patency of fallopian tubes. This has been mostly replaced by HyCoSy, and rarely offered by most fertility clinics.
ERA or Endometrial Receptivity Analysis
Endometrial Receptivity Analysis, or ERA in short, identifies your optimum ‘window of implantation’. The womb goes through a number of changes from ovulation until implantation. During this period, it produces a range of proteins and secretions that may help with implantation. All these changes are guided by expression of various genes. With the help of latest technology, we can check for over two hundred and fifty genes that are expressed in womb lining. Using this information, our fertility specialists can precisely plan IVF procedures, especially in patients with previous failed IVF and maximise your chances of getting pregnant. For this test, you will go through a minor gynaecological procedure like an endometrial biopsy, which requires a small sample from womb lining. This is then tested genetically to find out about your ‘window of implantation’.
Genetic tests
We offer a range of genetic tests such as karyotype, male fertility genetic tests, carrier genetic testing or mutation analysis specific to an already diagnosed condition in your family. These tests may be applicable to either one or both partners depending on your specific circumstances. Once you have been seen by a specialist, then we will arrange a blood test or a cheek swab. The report may take from few days to up to eight weeks, and this will be discussed at your next appointment.
Pelvic ultrasound scan
This is a transvaginal scan that gives us information about conditions such as uterine fibroid, endometrial poly, cysts on your ovaries or signs of damaged tubes that may affect your fertility. It also tells us about the ovarian reserve, which is measured as antral follicle count. It is a minor vaginal procedure, which may be slightly uncomfortable. That said, most women tolerate procedure extremely well and do not find it painful. This can be done as two- or three-dimensional procedure.
Antral follicle count or AFC
This is a measure of the number of very small follicles within the ovaries and done as part of the fertility ultrasound scan. This tells us about your ovarian reserves and gives our specialist more in-depth information to formulate individualised treatment plans for our patients. This requires a vaginal ultrasound scan to measure antral follicle count between both ovaries.
Endometrial biopsy
This is a minor gynaecological procedure during which a small sample is taken from the womb lining. Depending on your circumstances, specific tests will be done on this sample. These tests will give us information about silent infections or abnormal changes within the cells of womb lining. In some couples, treatment of these conditions may improve their chances of conceiving naturally or following fertility treatment.
Male Fertility Tests
Semen Analysis
Semen analysis is a basic fertility test that most men have to undergo as part of routine investigations for male infertility or as part of male fertility MOT. You will need an appointment for this test and the semen sample is analysed within an hour of production. This test will tell us your sperm count, movement or motility, morphology or percentage of normally shaped sperms, presence of inflammation and anti-sperm antibodies. There are a number of conditions, such as infection, inflammation, varicocele, trauma, surgery or other medical conditions that may affect sperm health. A low sperm count, motility or morphology may affect your fertility. Based on your report and a thorough assessment, fertility specialist will advise you on your next steps.
Sperm DNA Fragmentation Index or Sperm DFI
Sperm DNA Fragmentation index or Sperm DFI is a test that is performed on semen sample and gives us information about the extent of damage in the genetic material of sperm cell. Like semen analysis, you will book an appointment and produce the sample in clinic. The sample will be carefully assessed and the report is available in one to two weeks’ time. If you are suffering from infection, injury, inflammation or stress of any kind, this may affect the environment in the testes. This results in oxidative stress and causes release of harmful chemicals that may damage sperm cell. This in turn will affect the function of sperm and cause male infertility. An excess oxidative stress may affect success of various fertility treatment.
Reactive Oxygen Species Test or ROS test
Reactive Oxygen Species Test or ROS test is a male fertility test which gives information about presence of free radicals in semen sample and may damage sperms. It measures the oxidative stress that the sperms may be exposed to. Free radicals are formed in the sperm cells as by-products of oxygen metabolism. Small amounts of ROS may be required for starting some critical sperm functions in attaching and activating the egg cell or oocyte. But in excess, it may compromise your fertility.
Sperm Aneuploidy
Sperm aneuploidy measures presence of chromosomal arrangement disorders in five chromosomes out of the 23 pairs of chromosomes within the sperm cell. These are the most commonly prevalent chromosomal disorders that affect male fertility and can be detected by current testing methods. This test is done on a semen sample and like other male fertility tests, you will need an appointment to take this test.
Male Infertility Genetic Tests
There are a number of genetic or chromosomal conditions that may cause male infertility. This may show up as very low sperm count or absence of sperms on semen analysis. It is important that before proceeding with fertility treatment, we have better understanding of the possible causes including genetic conditions, such as Klinefelter syndrome. There are treatments that may prevent such conditions from being passed on to next generation. Not everyone with low sperm count benefits from such tests. Our specialists will advise if you are likely to benefit from such tests.
We offer full range of fertility tests for men, women and couples. Here we have outlined only a few common fertility tests. In case you are looking for a test that is not listed here or for more information, please contact clinic and our team will be able to provide more details of our services.
