The doctor. Hernández de la Clínica IVF Madrid details what are the different tests that must be submitted to women and men to evaluate their fertility. For couples looking to have a child with help it is important to know the requirements to start a fertility treatment. In the case that the woman is under 35 years of age, the couple has been having sex for two years without protection and without achieving pregnancy; and if you are over 35, the waiting time is reduced to one year.
The first test that will be done, in case it is a heterosexual couple, is a semiogram that will be done to the male. It is a non-invasive test that is done with semen. The results, which are obtained in two hours, will allow to know if the cause of the infertility problems is in the male. In the microscope the number of spermatozoa, their mobility and motility are analyzed.
With the same sample the sperm recovery test will be done, to analyze the semen in a culture medium. If the test result is very negative, a testicular biopsy requiring sedation may be prescribed to remove a small piece of testicle.
This biopsy evaluates if there is an absence of vas deferens, that is, that the sperm can not join the semen when ejaculating. It is a test to which only 1% of men who consult a fertility specialist are subjected .
If these tests attribute to man the problem of infertility, the ideal option is an in vitro fertilization or ICSI, the improved version of this technique, in which the best sperm are selected and, one by one, they are fertilized with the oocytes. of the woman.
When the problem is not in the male
In the case that infertility is not attributed to the male, a blood test is performed on the woman, for which it will be necessary to wait until the third day after the arrival of the period. FSH, LH and estradiol are three hormones that allow us to know what stimulation is necessary for in vitro fertilization.
If both this test and those of the male are good and, even so, the couple does not manage to have children naturally, then a hysterosalpingography will be done to the woman to observe the permeability of the tubes. Performed by a radiologist, it consists of introducing a vaginal contrast and seeing by image how it moves through the tubes. The goal is to see if artificial insemination can be done. After two or four unsuccessful artificial insemination attempts will be made in vitro fertilization, with or without ICSI .
For the woman who comes alone or with a partner of the same sex, it is necessary to perform the same hormone and permeability measurement tests to know if it is necessary to resort to insemination or to in vitro fertilization with donor sperm.. Once the treatment is decided, the first ultrasound will be done, to observe the quantity of antral follicles.
Here the medical tests for most patients will be over. But there are other tests that, although they provide more information, this does not translate either into an improvement in the diagnosis or the success of the therapies.
This is the case of the analysis of the karyotype that tries to locate aneuploidies in embryos already fertilized in vitro and it is recommended to women who undergo repeat abortions or fail, for unknown reasons, success with IVF. Other of these tests look for coagulation problems with blood tests of up to 15 variants. There are also the investigations of implantation in the uterus, in which a biopsy is included and the analysis of the genes that are expressed when the endometrium prepares to receive the embryo.