Infertility- Which Tests Are Necessary?

What is needed for pregnancy?

In the male partner, sperms are produced in the testes and are then carried through the sperm conducting ducts (epididymis, vas, seminal vesicle and prostate gland). Finally the sperms are deposited inside the vagina.

In female partner, the deposited sperms travel from vagina into the uterus and then reach the Fallopian tubes (the tubes that are attached to the both sides of the uterus) where the sperms must meet the egg (ovum). The ovum released from the ovary (“ovulation”) enters the tube and thus inside the tube an embryo (earliest form of the baby) is formed, by meeting of the egg and the sperm.

Therefore, 4 things are needed and these are tested-

1) Semen Analysis of the husband- to see if the sperms are OK or not.

2) Uterus and the Ovaries of the wife- by TVS 

3) Tube of the wife- by HSG 

4) Condition of the ovaries of the wife- by AMH.

Semen Analysis

It must be done from an authentic laboratory after 3 days of abstinence (no intercourse and no masturbation for 3 days). If it’s OK, no further tests for the male partner is usually required.

TVS (Trans Vaginal Sonography)

Although, the usual ultrasound scan, done over the abdomen, gives some information, TVS gives better information about the ovaries and the uterus. It is done by inserting the ultrasound probe inside the vagina. It may cause little discomfort but is not usually painful.

HSG (Hystero-Salpingo-Graphy)

It is a type of X Ray done after inserting saline water through the vagina. It’s usually done between day 8 and day 12 of the period.

AMH (Anti Mullerian Hormone)

Blood is tested for this hormone to see if the ovaries are functioning well or not.

Additionally, some tests are needed to ensure that both the mother and baby remain healthy during and after pregnancy. This is called “Preconceptional care”. This includes some routine tests like blood group, thalassaemia screening and tests for Rubella virus (this virus can cause birth defect in the baby).

Therefore, for infertility only few tests are required- Semen Analysis, TVS, HSG, Blood test (for AMH, blood group, Thalassaemia and Rubella)