fertility clinic tests

Most fertility clinics are staffed with sympathetic, attentive healthcare providers and nurses who help to ensure that evaluation is as stress-free as possible. Some tests may require samples from both you and your partner, which then need to be analyzed by a laboratory.

• blood work-up
• screening for STDs
• sperm penetration or sperm function tests
• the hemizona test for sperm binding
• the hamster egg penetration test
• questionnaires

blood work-up

A blood test can determine if adequate hormone levels are being secreted in your bloodstream. Depending on when the blood is taken, the healthcare provider can evaluate various aspects of your menstrual cycle. Different hormone levels may be measured with samples taken at different times of the menstrual cycle. For example, measuring the levels of FSH (follicle stimulating hormone), LH (luteinizing hormone) and estradiol in the first two to four days of the menstrual cycle gives an indication of ‘ovarian reserve’, one measure of a woman’s reproductive potential. Another blood sample is generally drawn about seven days after expected ovulation that measures the progesterone level. An elevated progesterone level indicates that ovulation (the release of an egg) has occurred.

These blood tests can be done at your healthcare provider’s office or in a lab and take only a few minutes. Women should be prepared to have several blood tests taken during their initial work-up. For women undergoing stimulation with drug therapies, blood tests will be required on a more frequent basis.

top

screening for stds

Sexually transmitted diseases (STDs) are a leading cause of infertility. When most people think of STDs, they think of AIDS, syphilis or gonorrhea. But there are several common STDs that people may not be aware of that can affect their fertility. Due to their prevalence and the impact they can have on fertility, screening for and ruling out STDs is one of the first tests a healthcare provider may perform in the work-up. Since these diseases are sexually transmitted, both you and your partner should be screened and treated if the results are positive or if you can continue to infect each other.

Chlamydia is a bacterial infection that is spread by vaginal, oral or anal sex, making it one of the most widespread STDs. The Centers for Disease Control estimates that over four million people are infected with chlamydia. In women, chlamydia can do permanent damage if not treated and can eventually lead to pelvic inflammatory disease (PID), which is one of the major causes of infertility among women of reproductive age. In men, chlamydia can infect the epididymis (where sperm is stored) causing it to malfunction and corrupt sperm. This condition, known as epididymitis, causes the testicles to swell during infection and can lead to sterility in some cases.

Chlamydia has no symptoms in men or women and goes undetected and untreated in many instances. Determining if chlamydia is present is a simple procedure done in the healthcare provider’s office. By inserting a cotton swab into the tip of a man’s penis, the healthcare provider can capture a bacterial culture to test for chlamydia. In women, a sample of cervical secretions can be analyzed to detect the presence of chlamydia.

Another common STD for which your healthcare provider will screen you and your partner is ureaplasma and mycoplasma. Alternatively, some healthcare providers may prescribe a short course of antibiotics to treat any potential STD and avoid the inaccuracies of testing for the specific diseases.

top

sperm penetration or sperm function tests

In normal fertilization, sperm bind to the outer coating of the egg, with one sperm eventually penetrating the egg barrier and fertilizing the egg. In some cases of male infertility, there may be a deficiency in the ability of the sperm to either bind to or penetrate the egg. There are two different tests that your healthcare provider could order that can aid in determining the likelihood of the sperm functioning properly once it gets to the egg.

top

the hemizona test for sperm binding

A non-living (non-viable) donated egg is cut in half under the microscope. One half of the outer coating is placed with donated sperm that has proven fertility as the control. The other half is placed with the patient’s sperm. The number of sperm that bind (attach) to each respective half are compared. Very low binding can indicate a problem with the sperm’s function.

top

the hamster egg penetration test

Sometimes healthcare providers will perform an experiment to see if the man’s sperm can successfully penetrate the woman’s egg. To do this, the sperm is actually tested with a specially prepared hamster egg (the human sperm do not actually ‘fertilize’ the hamster egg). The ability of the sperm to bind to the egg and achieve penetration is measured. If there is good penetration in the test situation, there is a good chance the sperm are capable of inseminating a human egg.

Penetration tests are not absolute predictors -- effective sperm can fail the penetration test, just as ineffective sperm can succeed. For this reason, penetration tests are rarely used. Still, the sperm function test may have its usefulness in cycles of intrauterine insemination. If pregnancy does not occur, these tests may help to identify or rule out a sperm issue that a normal semen analysis might not detect. When the test is used, it is usually performed in conjunction with a semen analysis. It also may help in the decision regarding the best method of fertilization to use in in vitro fertilization (IVF) – standard insemination versus intracytoplasmic sperm injection (ICSI). The penetration test does not reveal any information about the sperm’s abilities in other vital areas of fertilization, such as acrosome reaction. Tests to check the acrosome reaction are sometimes done when the healthcare providers believe there is a problem.

top

questionnaires

Some fertility clinics mail out a questionnaire prior to a scheduled visit so the physician can review before the couple comes and use the office time more efficiently. The clinic will ask for information about medical and sexual history as well as information about a person’s social and personal life. Men might be asked about any history of the following:

• Testicular injuries
• Mumps
• Surgery
• Allergies
• Exposure to heat
• Exposure to environmental toxins

The answers to a few of these questions are often easier to answer in written form than face-to-face.

top