Tests for Female Fertility

We at Rotunda believe in tailor made tests and treatment. From a detailed history to an ultrasound scan and from basic blood tests to sophisticated blastocyst biopsies all are done at Rotunda. We start with baseline tests for detecting anaemia or raised sugars, hormonal tests for thyroid disorders TSH, Antithyroid antibodies, or Prolactin levels or to determine ovarian reserve or polycystic ovaries viz the AMH, FSH, LH or fitness tests. Where indicated cancer screening is offered by a Pap smear, endometrial biopsy or blood tumour markers or an infections screen that includes HIV, HbsAg, HCV antibody testing and a VDRL as well as an HSV testing if indicated.

All this is offered under one roof. This helps us accurately diagnose and hence institute the proper treatment without patients running to multiple clinics. With modern ultrasound machines many of the multiple hormone tests like regular Estradiol or progesterone levels are done away.

We test only what is necessary to make the entire treatment as painless and low cost as possible. A minimum of tests appropriate to a patient are advised.

Male factor problems may be related to:

Inadequate or abnormal sperm production and delivery

• Anatomical problems
• Previous testicular injuries, or
• Hormonal imbalances

The male partner provides a semen sample that is analyzed with a battery of advanced andrology tests in our fully-equipped laboratory. In addition to the standard semen analysis using World Health Organization (WHO) criteria, we also analyze sperm to assess the number of motile sperm that can be extracted from the ejaculate.

We encourage male partners to have their semen analyzed at our Laboratory so their samples can be tested against rigorous standards. In addition to the routine analysis of morphology, motility, and concentration, some of the additional testing we perform on the semen includes:

• Routine semen cultures to detect infections
• Pre and post-processing to determine what to expect for IUI or IVF procedures
• Testing for antisperm antibodies and for IgA, IgM, and IgG antibodies
• Long-term survival studies
• Detection of biochemical markers in the semen, e.g., fructose testing and also additional diagnostic testing for patients with severe male problems e.g. Hos Test

In cases where the semen analysis is normal, treatment will focus on the work-up of the female partner only.

According to WHO a normal semen analysis includes:

• Asperm concentration of greater than 20 million sperm/ml
• Motility (movement) of greater than 40%, and
• Avolume greater than 2cc

Additionally, our laboratory uses the Kruger classification of more than 14% normal morphology.

Abnormal semen analysis – An abnormal sperm analysis is repeated first for verification. Typically, the male partner is referred to an urologist for evaluation. If the urologic evaluation is normal, results of the sperm count determine further treatment. For example, a total motile sperm in excess of 0.5 – 10 million would make intrauterine insemination an option. If the number is less than a 1 million, ICSI would be a better course of treatment.

Anti Sperm antibodies – Anti-sperm antibodies are substances that attach to the surface of the sperm and may interfere with the ability of the sperm to move & penetrate the cervical mucus, or to fertilize an egg. They must be done when infertility is either unexplained, following an abnormal postcoital test, or when significant sperm coagulation is noted in the initial semen analysis. Our laboratory uses the immunobead technique to detect sperm antibodies. If they are detected, sperm washing in conjunction with IUI or IVF is considered.