Fertility Tests

Successful conception depends upon many complex processes in you and your partner. Before any treatment starts, our specialists will perform infertility tests to discover the cause (s) of your infertility.

These tests are important because quite often there is more than one cause of a couple’s inability to conceive. You could have an ovulatory problem that would respond to Clomid, while at the same time having large fibroids in your uterus, or your partner could be sub fertile. Male factor infertility is present in up to 50% of cases so the semen analysis must be done before any therapy begins.

Infertility tests are designed to access each part of the reproductive process. In general, these processes include:

• The male must produce sufficient sperm of good quality and ejaculate them into the female’s vagina.
• These sperm must be capable of swimming from the vaginal canal, through the cervix, and into the uterus.
• The sperm must travel to the end of the fallopian tube, and one must attach to and penetrate an egg(s). It must be capable of fertilizing the egg.
• The female must have ovaries with eggs that can develop and be fertilized.
• The hypothalamic/ pituitary/ adrenal axis must control and react to the varying levels of hormones such as FSH, estrogen, LH and others. FSH stimulates the recruitment and development of the follicles, each of which contains an egg.
• The eggs must mature during the ovulatory cycle and the endometrium (lining of the uterus) must become more vascular to accept a developing embryo.
• Once the eggs mature, the hypothalamus signals the pituitary gland to release a surge of LH which causes ovulation 36 hours later.
• The eggs are ovulated and “picked up” by the fimbriae of the fallopian tubes.
• Sperm must fertilize the egg (s) at the end of the fallopian tube. One sperm must attach to and penetrate the egg’s cell membrane and initiate fertilization.
• The male and female gametes (sex cells) must be genetically normal
• The fertilized egg, or embryo, must attach to the lining of the uterus and continue cellular growth.
• The corpus luteum, which is the follicular structure remaining after ovulation, must begin to produce progesterone to support endometrial growth.
• In early pregnancy, the placenta begins to produce progesterone.
• The uterus must be free of polyps, fibroids, or congenital abnormalities that could restrict fetal growth.
• The mother must be physically capable of carrying the baby to term and delivery.

Your partner may have a normal semen volume and still be sub fertile. Viable sperm must be produced in his testicles, they must be transported through the vas deferens, past the prostate gland, through the urethra and ejaculated out the penis. Once deposited in the vagina, they must swim through the cervical mucus, past the cervix, and into the uterus. One sperm must attach to, and penetrate, an egg and be capable of fertilization.

The semen analysis examines many factors according to the Kruger Strict Criteria or the World Health Organization Criteria. In general, the semen analysis includes: Volume of sperm in the ejaculate- the normal value is more than 20 million sperm/milliliter. Motility (ability to swim)-More than 50% should be actively motile (moving) More than 14% normal forms- the heads and tails are properly shaped. Less than 5 white blood cells per high power microscope field. More could indicate infection or antibodies. Other characteristics, such as viscosity, are also evaluated.

The time required for sperm cells to develop to maturity is three months. A semen analysis done today reflects the conditions affecting sperm development three months ago. For example, the scrotum performs the vital function of controlling the temperature of the testicles. If the temperature of the testicles needs to be lowered the scrotum expands moving them further away from the body. The reverse happens when the temperature of the testicles needs to be increased.Read about male infertility