By Tan Yi Lin


If you are newly married, you might be taking a year or two to enjoy life as a couple before you start trying for a family. Consider using this time to undergo pre-conception tests to assess yours and your spouse’s fertility health. It can take up to a few months for the tests to be conducted and the results analyzed, so you can ‘save time’ by getting them done early on in the marriage. This is something you will appreciate once you’re ready and raring to go and want to conceive as soon as possible.


If you have already been trying to conceive for six months to a year without success, undergoing fertility tests is a good way to find out what exactly is making conception such a challenging task.


The following is a series of tests commonly used to diagnose fertility problems:


1. Blood Tests


What is it:
Blood samples from the female are drawn on different days of the menstrual cycle. A blood test is usually the most basic and the first test conducted to assess fertility health.


Why do it:
To check for and diagnose hormonal imbalances, which can affect the ovulation cycle and thus a woman’s ability to get pregnant.


How it works:
A combination of follicle-stimulating hormone (FSH), luteinising hormone (LH) and progesterone are involved in egg production. A few blood samples are drawn to separately test for each hormone. An additional blood sample may be drawn to test for immunity against rubella, which if contracted during pregnancy, could harm the foetus.


If the levels of any particular hormone are too low or too high, medication (e.g. progesterone supplements) is issued to help bring these levels in check. If immunity against rubella is non-existent or low, vaccination will be carried out.



2. Hysterosalpingogram


What is it:
A harmless dye or saline solution is injected through the cervix through a catheter into the uterus and fallopian tubes. The test is conducted between Days 7 and 10 of the menstrual cycle so as to ensure that the woman is not pregnant.


Why do it:
To check for abnormalities in the structure of the uterus and tubal blockage (usually the result of the accumulation of scar tissue from previous infections), which can reduce the chances of successful conception.


How it works:
A ‘live’ x-ray during the test showing the flow of the dye will reveal the presence of irregularities and/or blockage. Some patients experience abdominal pain or cramps during and after the procedure, which usually subside within a few hours.


Surgery to remove tubal blockage or the use of In-Vitro Fertilization treatment.



3. Ultrasound Scanning


What is it:
A camera is inserted via the vagina to obtain pictures of the womb and ovaries.


Why do it and how it works:
Ultrasound scanning can pick up uterine irregularities such as fibroids and also measure the thickness of the uterine lining. A scan of the ovaries can also show if the eggs are developing properly and if they are being released from the ovaries. The presence of fibroids, irregular ovulation, polycystic ovarian syndrome (PCOS) and a thin and unstable endometrial lining can make conception difficult. Thus, early detection and treatment of these health issues is important.


Fertility drugs and surgery.



4. Sperm Analysis Test


What it is:
The male partner will produce a fresh sample of semen for laboratory evaluation. To ensure accuracy of the results, the partner is usually advised to discharge through ejaculation three days prior to the test and then refrain from ejaculating again until the sample is produced. The sample can be produced at home or at the clinic in a sterile container provided by the clinic and is usually analyzed within two hours of collection.


Why do it:
To check for sperm health issues such as low sperm production or slow-swimming sperm.


How it works:
Male fertility problems can also be a barrier to pregnancy. Low sperm count basically means fewer chances of successful fertilization. Low sperm motility or sluggish sperm results in fewer sperm making their way up the full length of the vagina and into the womb where the egg resides. Deformed sperm structure also hinders the chances of successful fertilization. Semen fluid is also evaluated with regard to thickness, acid level and sugar content.


Fertility drugs, surgery or the use of assisted reproduction methods such as In-Vitro Fertilization or Intra-Cytoplasmic Sperm Injection.



What Next?

The test results will give you and your doctor a better idea of the fertility challenges that lie ahead (if you are not planning to conceive just yet) or what exactly is making conception so difficult right now (if you have already been trying for some time).


Your gynaecologist will bring you through the treatment options available and if necessary, refer you to an IVF specialist for further follow-up. Age plays a big part in the chances of successful conception, so if you feel that you cannot afford to wait, you may want to opt for treatment sooner rather than later. Your doctor will be there to help you reach the best decision for your individual case.



*The author brings you this information through her personal experience with fertility treatment.





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