One in six Australian couples experience trouble conceiving. A good first step is to see a Fertility Specialist who can assess your overall reproductive health and conduct some simple tests to identify any underlying causes of pregnancy delay.
These fertility tests typically include:
- Female infertility tests: a combination of blood tests and ultrasound scans to help identify any specific issues such as PCOS or endometriosis and to check ovulation is occurring each month.
Semen analysis: the most important male fertility test which measures the number of sperm in a sample as well as their motility and morphology. Find out more about a semen analysis including how to book a semen analysis…
Genetic testing: for patients who are at risk of a variety of inheritable conditions we offer sophisticated scientific techniques to test for genetic disorders including pre-implantation genetic testing, karyomapping, and non-invasive prenatal testing. Find out more about genetic testing.
Causes of infertility
Causes of infertility are many and varied and involve male, female or a combination of factors. They include problems with:
- the production of sperm or eggs
- the structure or function of male or female reproductive systems; and/or
- hormonal and immune conditions in both men and women.
After a woman’s age, a little known fact is that male infertility is the biggest single factor influencing a couple’s chance of conception [40% sperm related cause].
In 10-20% of couples no cause will be found, this is called Unexplained Infertility, which can be particularly frustrating for you and your partner.
You may have undergone preliminary testing with your GP or referring gynaecologist. Your fertility specialist will review your results and history before recommending a treatment plan. Before we determine the best treatment plan for you, further investigations may be necessary and typically these can include:
You’ll need a blood test to check whether or not you are ovulating, or producing an egg every month. This can be carried out at your IVFAustralia clinic during clinic hours.
An ultrasound scan checks the lining of your womb (endometrium) and diagnoses any conditions that may be distorting the lining.
It allows us to check:
- If you have any fibroids or polyps, which could affect your cycle
- If you have any ovarian cysts
- How easy it will be to collect your eggs from the ovaries
- The size of your ovaries and if there are many small follicles.
It also gives us a baseline report to compare with later in your treatment.
Ovarian reserve (AMH test)
We usually recommend having an AMH blood test to measure ovarian reserve hormone called Anti Mullerian Hormone (AMH). This simple blood test provides a very good estimate of the number of eggs that you still have in your ovaries. Your fertility specialist can then explain whether your ovarian reserve is ‘normal’ for your age.
Checking your fallopian tubes and uterus
Additional tests may be needed to check your tubes are open (tubal patency), and the condition of your uterus and ovaries:
- Sonohysterogram or HyCoSy - a relatively non-invasive test, which involves an ultrasound and insertion of a tiny tube into the cervix to pass dye through the uterine cavity and tubes.
- Hysterosalpingogram - using X-rays to confirm the fallopian tubes are open (this does not provide any information about the ovaries and provides only limited information about the uterus).
Diagnostic laparoscopy and hysteroscopy
These tests are more invasive and so usually come last – in some cases you may not need the tests at all.
Laparoscopy is performed under general anaesthetic. A fibre optic telescope (laparoscope) is passed through a small incision in the umbilicus and a manipulating probe is inserted through the pubic hairline, to view the ovaries, fallopian tubes, uterus and pelvic cavity for abnormalities. Tubal patency can also be checked by injecting dye through the uterus and observing its progress. Often two additional small incisions are made if treatment or pathology is required.
Hysteroscopy uses another fibre optic device (a hysteroscope) to study the uterine cavity for polyps (benign growths), fibroids, adhesions and abnormal anatomy.
The fertility panel is a blood test that has been designed to investigate genes which are specifically associated with difficulties in conceiving or maintaining a pregnancy.
In both males and females can test for;
- Cystic Fibrosis
- Prothrombin and Factor V Leiden
- FSH receptor
It recommended that anyone who is experiencing pregnancy delay, or has had more than one miscarriage may benefit from this test. You should discuss this test further with your fertility specialist.
The fertility panel is most beneficial when both people are tested.
If you are trying to conceive a simple fertility assessment can give you a clear picture of your reproductive health. Call 1800 111 483 to book an appointment with a fertility specialist.
Appointments are available in the next couple of weeks and will cost approximately $150 for a couple after the Medicare rebate.