Infertility Test for Couples: Diagnosis, Procedures, and Costs

Fertility problems can be caused by both men and women. Infertility test is the best way to determine whether you're infertile and what the problem is.

Infertility is defined as not being able to get pregnant after one year of regular unprotected sex and six months of unprotected sex if you are over 35.

Male Factors

• Problems with sperm production.
• Problems with how sperm is transported.
• Problems with sex or ejaculation.
• Other factors, such as exposure to heat or chemicals, high levels of stress, other medical conditions, etc.

Female Factors

• Problems with egg production or ovulation.
• Problems with the pelvis or fallopian tubes.
• Problems with the cervix or uterus.
• Problems with the vagina.
• Other factors, such as not having sex frequently, high levels of stress, other medical conditions, etc.

• Irregular or no periods due to problems with the ovaries, preventing ovulation, usually caused by hormone imbalance.
• Excessive bleeding during a period with severe abdominal pain due to abnormal uterine contractions, which may be caused by endometriosis.
• Lack of interest in sex or a decreased libido that leads to diminished sexual ability, which may be caused by certain medical conditions; see a doctor as soon as possible.
• Gaining or losing too much weight, causing dramatic shifts in the body that can impact fertility and reproductive ability as well as increase the risk of miscarriage.
• As we get older, our hormones change, decreasing the chances of becoming pregnant while increasing the risk of abnormalities in the fetus (this is especially true for women over the age of 30).

For women fertility testing focuses on examining the uterus, fallopian tubes, and female hormones to see if each component of conception and embryo implantation works normally or not, if there are any obstructions, or if there is a condition that prevents the embryo from implanting. Testing usually includes:

• Using a small camera to look in your uterus
• Using a transvaginal ultrasound to look for cysts or tumors in the ovaries, tumors in the uterus or endometrium, or tumors in the pelvis
• Check hormone levels through blood testing

For men fertility testing focuses on semen using a semen analysis, which examines both the semen and sperm in it, to check for:

• Number of sperm in semen
• How quickly sperm move
• Size, shape, and health of sperm

1. Semen Analysis

Fertility assessment in men is done through semen analysis (counting number of sperm using a microscope, analysis with CASA computer and dye to examine the structure of sperm).

This test provides information about semen, including quantity of semen and the number, shape, and motility of sperm.

When collecting semen for analysis, avoid ejaculating for 5-7 days before the day of collecting. Semen should be collected at the clinic where it will be analyzed. If results are abnormal, the test might be repeated to confirm results.

2. Hormone Testing

Blood testing is usually done if problems with hormones are suspected.

Genetic testing may be done to rule out any genetic or chromosomal abnormalities that can cause infertility. Infertility can sometimes be caused by a missing or abnormal male chromosome (chromosome Y).

Some men can pass on genes related to cystic fibrosis, which can cause infertility due to problems with the vas deferens. In this case, the doctor will discuss all the risks and consequences of passing on certain genetic conditions.

1. Blood tests

Blood tests can measure levels of hormones like follicle-stimulating hormone (FSH) as well as estrogen and progesterone, which indicate ovarian function and the number of eggs remaining.

Furthermore, blood tests may be done to check thyroid function and the prolactin hormone to rule out pituitary gland tumors.

However, assessing ovarian function using FSH and estrogen is no longer popular as the test must be done on the 2nd to 5th day of your cycle.

A better way to measure ovarian reserve is by testing the anti-Mullerian hormone (AMH), which provides a more accurate result and doesn’t change through the cycle. This test is more convenient for patients as it can be done any day of the cycle.

2. Hormone Testing

Hormone testing is usually done along with assessing ovulation. Ovulation is an important step in conception. Abnormal ovulation can be diagnosed through irregular periods or abnormalities of certain hormones, such as the luteinizing hormone (LH) in the first half of the cycle (before ovulation) or progesterone in the last half of the cycle (luteal phase).

• Irregular menstruation is a sign of irregular ovulation or chronic anovulation, which prevents conception and causes infertility
• Luteinizing hormone (LH) rises 38 hours before ovulation and can be tested for at home using an ovulation test that can be bought at any drugstore. However, these tests have a 15% rate of incorrect results.
• Testing progesterone levels is a more accurate way to assess ovulation as levels increase after ovulation.

3. Pelvic Examination Ultrasound

A transvaginal ultrasound provides a clearer image of the uterus and ovaries in comparison with an abdominal ultrasound. A small transducer is inserted into the vagina to measure the size and shape of the uterus and ovaries and to detect any abnormalities, such as tumors or cysts.

If any abnormalities are found, additional testing will be required, such as a hysterosalpingogram to look at the fallopian tubes and uterus.

Women

If you have regular periods, the best time for testing is on the 2nd or 3rd day of the cycle (consider the 1st day of your cycle to be the 1st day that your period starts) as it is the best time to check hormone levels.

If your periods are not regular, there is no need to wait for a cycle. Try to note the last six months cycles to use as information about ovulation in the past.

Men

Testing can be done as convenient, but avoid ejaculating for 5-7 days so semen can be collected and sent for analysis on the same day. If more or less time has passed since ejaculation results will show a decline in sperm motility.

1. Start out by seeing the doctor to talk through your health history and your family history, your periods, and how frequently you have sex, as well as undergo a thorough health screening and internal examination to check for any abnormalities.
2. Blood tests can detect genetic conditions like thalassemia and conditions that can be passed from the mother to the baby. Blood tests are also done to check hormone levels to assess the function of the ovaries and other organs.
3. Additional testing may include ultrasounds, blood testing related to ovulation, hysterosalpingogram, hysteroscopy to visualize the uterus and pelvis, etc.
4. Use all the test results to settle on the reasons for infertility.
5. Treatment will be specific to the diagnosis: ovarian stimulation to cause ovulation, treatment for hormonal imbalance, assisted reproductive technologies as needed, such as intrauterine insemination and IVF/ICSI, and surgery for blocked fallopian tubes or to remove tumors.
6. In men, testing includes a semen analysis. If results are abnormal, the test is repeated to confirm results before treatment planning.

1. IUI

Intrauterine insemination or IUI is most like natural intercourse. The doctor will prescribe medication to increase the size and number of eggs. The healthiest sperm will be chosen and then injected directly into the uterus to help the sperm reach the egg.

2. IVF

In-vitro fertilization or IVF involves selecting an egg to be fertilized by sperm in a laboratory, where the embryo will grow into a blastocyst (5 days) before it is transferred back into the uterus to grow in pregnancy.

3. ICSI

Intracytoplasmic sperm injection or ICSI is an additional step in the IVF procedure where an ICSI machine is used to inject sperm directly into the egg instead of waiting for the sperm to travel to the egg itself.

4. Egg Freezing

Egg freezing involves collecting eggs and freezing them to stop them from aging and preventing natural deterioration. As a woman ages her eggs diminish in quality and conception is more difficult.

Currently many families in developing countries experience infertility due to changing lifestyles. Women wait longer to get married and have children. Freezing eggs when younger is a growing trend.

At Beyond IVF our doctor has more than 20 years of experience in treating infertility and is also an obstetrician and gynecologist, with credentials from Ramathibodi Hospital that guarantee his knowledge and experience. Our team, including our scientists and nurses, have experience and training in this field.

Our complete infertility testing package that includes testing for both partners is perfect for those trying to conceive, those having difficulty conceiving, and those who would like more information before beginning treatments like IUI and IVF. Our infertility testing package is 14,000 baht and includes:

For Women

• Transvaginal ultrasound.
• Thin Prep test to check for abnormalities of the cervix.
• Blood test to rule out the following infections: HIV, syphilis, and hepatitis B.
• Hormone testing: FSH, LH, prolactin, E2, P4, AMH.
• COVID-19 testing.

For Men

• Semen analysis:
  • Volume must be equal to or more than 1.5 ml (>1.5 ml)
  • Sperm concentration must be equal to or more than 15 million/ml (>15M/ml)
  • Motility must be equal to or more than 40% (>40%)
  • Morphology must be equal to or more than 4% (>4%)
  • Other factors, such as pH balance, antibodies, white and red blood cells, viability, etc.

• Blood test to rule out the following infections: HIV, syphilis, and hepatitis B.
• COVID-19 testing.

Thorough health screening for families experiencing infertility is essential as there are currently many treatment options for infertility. If you are having difficulty conceiving, see a specialist as soon as possible for testing to diagnose the cause of infertility and for the appropriate treatment planning. Your doctor will design a treatment plan specific to your situation.

If there are any questions, please contact us via Line @beyondivf