What Should I Do for Infertility Testing Part 1: Screenings

Fertility and Pregnancy

Several tests are necessary to determine the cause of your difficulty in having a child and the current state of your body. If there is a definite cause, this will need to be addressed. Along with tests to find the cause of infertility, it is also advisable to check the safety of getting pregnant when starting infertility treatment. 

Screening Tests

It is advisable to have a stable condition after treatment if you have a disease that may cause problems if you become pregnant.

Endocrine Test

The initial endocrine tests include the following:

  • Luteinizing hormone (LH)
  • Follicle-stimulating hormone (FSH)
  • Estradiol (E2)
  • Lactation hormone (PRL)
  • Luteinizing hormone (P4)
  • Testosterone (T)

Measurements may vary depending on the case and menstrual cycle. FSH, LH, and E2 are measured on days 3-7 of the menstrual cycle in the early follicular phase to evaluate ovarian function. In addition, PRL should be measured in cases of leaking milk, ovulation disorders, and abnormal menstrual cycles.

In cases where polycystic ovarian syndrome (PCOS) is suspected, it may be useful to measure testosterone as well. P4 measurement is useful in cases where luteal insufficiency is suspected based on changes in basal body temperature. It is performed in the mid-luteal phase. Hormone stress tests and thyroid function tests (TSH, fT3, fT4) are performed in cases where they are deemed necessary

Chlamydia Antibody Test

Chlamydia antibody tests (lgG, lgA) are very important as an initial test for infertility. lgG antibodies often remain positive even after cure if there is a previous infection, but it is necessary to take action even if there is a previous infection.

It is advisable to seek treatment together with your partner in cases of positive antibodies or IgA antibodies without a history of treatment and cases where the antibody test does not rule out current infection. The chlamydial antigen (nucleic acid identification) test is useful in diagnosing the presence or absence of chlamydial infection (infectivity) at the time of the test, but in some cases of advanced infection in the fallopian tubes or intra-abdominal cavity, the antigen test cannot confirm infection.

Fallopian Tube Invasiveness Test

The fallopian tubes can be examined by tubal drainage and hysterosalpingogram. It is necessary to confirm the menstrual cycle, the condition of the bandage, the presence or absence of allergies, and the negativity of chlamydia infection. Hysteroscopy may be useful to evaluate the morphology of the uterine lumen.

General Semen Analysis

A general semen analysis is a necessary test for the evaluation of the malefactor. It is advisable to perform this test early in treatment.

Sperm Cervical Mucus Compatibility Test (Huhner test: post-coital test)

Sperm cervical mucus compatibility test (Huhner test: post-coital test) is a simple test that can be performed on an outpatient basis without the need for special equipment. It is important to perform the test on the optimal test day (exactly on the day of ovulation) as identified by ultrasound and hormone tests. The antisperm antibody test can be used as a hint for treatment in cases of poor Huhoner test results. 

Other Tests

Other general gynecological tests such as uterine cancer test and vaginal bacterial culture test may be performed.

Tests whose timing is determined by the menstrual cycle

What? When? What for?
Menstrual hormone test

(Basic hormone levels)

2nd-5th day of menstruation Measures hormones (FSH, LH) and estrogen secreted by the pituitary gland to stimulate the ovaries.
Hysterosalpingogram Immediately after the end of menstruation A test to check the passage of the fallopian tubes and the condition of the uterine cavity.
Ultrasonography

(Follicle and endometrium check)

At any time This is done to predict the day of ovulation.
Cervical mucus test             Near the day of ovulation To check if the uterus is in good condition for ovulation.
Huhner test After sexual intercourse on the day of ovulation          This test is used to check the compatibility of the sperm with the woman’s side. Luteinizing hormone test Around 1 week after ovulation Evaluate the state of the luteal phase after ovulation.
Luteinizing hormone test Around 1 week after ovulation             Evaluates the state of the luteal phase after ovulation.

 

Tests that can be done at any time

  • Hepatitis B, Hepatitis C, Syphilis, HIV (blood status and infectious disease tests)
  • Blood type, blood count (anemia, platelets)
  • AMH Ovarian reserve
  • Chlamydia antibody test
  • Vaginal bacterial culture test
  • Uterine cancer test
  • Semen test
  • Your partner’s infection test: Hepatitis B, Hepatitis C, Syphilis, HIV

Conclusion

Before you want to get pregnant, it’s better to take some tests to make sure your body is healthy not only for you but also for your future baby. You can ask your gynecologist what test you should take and when.

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