Relating The Infertility Tests To The Process Of Pregnancy
There is a reason behind each infertility test. Each test is used to discover if a piece of the pregnancy equation is working properly or not. The pregnancy equation involves several factors on the male side and on the female side of the equation. Fertility specialists will order tests for the couple based on the results of a physical examination and a complete male and female medical history.
Pregnancy Equation Male Side
The factors for a successful pregnancy that are related to the male side of the equation are: A large enough number of sperm being ejaculated into the woman’s vagina, sperm that are healthy enough to navigate through the cervix and into the uterus. These sperm must then be able to continue the journey up the fallopian tube where they will meet with the Ova (egg). At the egg, they must be able to excrete an enzyme that breaks through the shell of the egg and one lucky sperm succeeds to penetrate into the egg. The sperm need to be able to accomplish each of these tasks if pregnancy is to occur.
Corresponding Male Fertility Tests
The male fertility test is called a SA or semen analysis. The statistic for infertility says that 50% of all infertile couples have a “male factor” infertility problem. So running this test is critical to eliminating possible problems or pinpointing exactly what the difficulty is. The SA will determine what the sperm quantity and quality are in the batch supplied by the male.
The Procedure
The male will need to abstain from sexual relations for 48 to 60 hours before the scheduled test. He then comes to the clinic (a few clinics allow the male to obtain the specimen at home as long as it is brought in to the clinic within an hour) where he will produce his semen specimen into a cup provided by the clinic. The test will then be conducted to find out if there are adequate numbers of live sperm in the specimen. The sperm will also be tested for morphology and the presence of white blood cells. The “Strict Morphology Assay” test on the sperm is done to be sure that the sperm are healthy and plenty enough to complete their task in the time that the egg is still viable (24 hours) from being released from the ovary. The sperm themselves can survive for 72 hours. This means that if the sperm is deposited in the vagina prior to the egg being released they have 60 hours of viable time before the egg is released to be in the environment waiting for the egg. This test assures that the sperm are healthy enough to endure the journey as well as the time frame.
Pregnancy Equation Female Side
On the female side of the equation what is needed is healthy eggs that have the ability to be fertilized by sperm. The fallopian tubes must be able to carry the egg along the tube until it reaches the end of the tube. The corpus luteum needs to be able to maintain enough progesterone to support the developing embryo until around gestation week 9 when the placenta will take over this function. The uterus is another factor in the female side of the equation. The endometrial lining needs to be thick enough to nourish the developing embryo. If one or more of these factors is not working properly conception will not occur, or will end in early miscarriage.
Corresponding Female Fertility Tests
The specialist will check to see if there are any records of ovulation test kits being used or charting software that may give clues to whether or not the female is ovulating. Blood tests will also be done that can determine if ovulation has occurred these tests are ordered by cycle day.
The Endocrine Profile is a test that is done around cycle day 3 – 5. The profile includes: FSH, LH, E2, Prl, DHEA-S, Testosterone, and TSH.
The Inhibin B is used to measure ovarian reserve. This test is done on cycle days 3 – 5. Women are given this test if they are over 35 years of age, have had previous ovarian surgery or when the specialist suspects ovarian failure. A Clomiphene challenge fertility test or (CCT) may also be conducted.
A Hysterosalpingogram (HSG) may be performed to take a look at the shape of the uterus and to see if the fallopian tubes are open or if they are blocked. This is an outpatient x-ray test.
Other tests that may be performed are: various ultrasounds, a record of the cervical mucus may be discussed, and a Post coital Test (PCT) may be conducted. There may be need for an Endometrial Biopsy to check on the endometrial lining, and an Endometrial function test (EFT) may be performed from 8 to 10 days after a LH peak has been detected. This test checks for the presence of certain implantation markers in the endometrial lining.
Still other tests may include a Laparoscopy or a Hysteroscopy.
