Fertility

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While some couples may find it easy to conceive, others struggle to have a child of their own. A good way to ensure that your body is physically ready for conception, is to consider taking preconception and fertility tests and examinations to assess your state of health and if necessary, go for treatment to improve your fertility. There are two types of tests: non-invasive and invasive.

 

Non-invasive tests include:

 

1. Basal Body Temperature (BBT) chart


This test is simple and easy to learn. It is cheap and has been used for ages as a guideline to detect ovulation.

 

2. Blood tests

 

These are used to check the levels of female hormones, thyroid hormones, and milk hormone (Prolactin). These would be useful if the menstrual cycle is irregular or absent. They can also be used to test for sexually transmitted diseases (STD) such as Syphilis, Chlamydia, Hepatitis B and HIV. These tests may indicate genital infections which may contribute to the fertility problem.

 

3. Semen Analysis

 

This is easily done by masturbation or by using nonspermicidal condom during sexual intercourse. The semen analysis will check the number, shape, and motility of the sperm. However, if the test is not normal in the first instance, it should be repeated as the values fluctuate considerably day by day and are dependent on many factors. If the semen analysis suggests low sperm count, blood tests on male hormones may be required.

 

4. Ovulation kits

 

There are many test kits in the market. The accuracy and false results vary. Generally, they are accurate in predicting ovulation.

 

5. Postcoital test

 

This test requires that you have intercourse several hours in advance before visiting your doctor to have a sample of cervical mucus taken for microscopic examination. It is a way of testing both the viability of the sperm and their interaction with the cervical mucus. The accuracy of this test varies depending on whether it is done at the time of ovulation and the cervical mucus is of good quality.

 

6. Transvaginal (pelvic) ultrasound exam

 

An ultrasound is done to check the condition of the womb (uterus) and ovaries. Often the doctor can determine whether the follicles (eggs) in the ovaries are working normally. Thus, the ultrasound is often performed 15 days before a woman’s expected menstrual period.

 

7. Hysterosalpingogram (HSG)

 

This is a procedure where a series of X-rays is taken of the fallopian tubes after a liquid dye has been injected into the womb (uterus) through the cervix and vagina. The HSG can help to diagnose fallopian tube blockages and defects of the uterus. If one of the tubes is blocked, the obstruction should be apparent on the X-ray since the liquid dye won’t get past it. An HSG is usually scheduled between days 6 and 13 of your cycle. The procedure can be uncomfortable and a blocked tube could be due to spasm since the patient is conscious.

 

Invasive tests include:

 

1. Hysteroscopy

 

In this procedure, a thin, telescope-like instrument is inserted into the uterus through the cervix to allow the doctor to see and photograph the area to look for problems. It is done under local or general anesthesia.

 

2. Laparoscopy

 

In this procedure, a laparoscope is inserted into the abdomen through a small incision to look for endometriosis, scarring, and other conditions. It is done under general anesthesia.

 

3. Endometrial biopsy

 

This procedure is done by removing a sample of tissue from the lining of the womb (endometrium) with a catheter that is inserted into the uterus through the vagina and cervix to see if it is normal. The procedure is somewhat uncomfortable therefore, a painkiller is given beforehand.

 

Not all women or men will need to undergo all these tests. Your doctor will guide you through those that are most appropriate for you. For couples experiencing difficulties in conceiving, about 85% of couples will have some idea why they are having problems getting pregnant after the tests.

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