At your first visit to The Scotia Clinic, we will take a detailed history from both yourself and your partner, who should of course be encouraged to attend.
If this isn’t possible, we will still need information on the following aspects of his history: surgery or injury to his genital area, history of undescended or absent testicles, history of chronic illness or long-term medications, previous parenting information, together with any other information that you think may be relevant.
If it’s appropriate, we may also carry out a cervical smear test and/or a Chlamydia test. We may also do an ultrasound and test your immunity to Rubella (German Measles).
Here is some more detail on the tests we may carry out, together with the reason for each test.
|Test||Information to be obtained|
|FSH, LH, Oestradiol blood test (day 3 of cycle)||How well your ovaries respond to fertility medications and whether they contain adequate numbers of eggs|
|Day 21 progesterone||Provides information about whether you are ovulating|
|Semen analysis||Sperm count, viability and function|
|Ultrasound scan||Identifies polycystic ovaries, ovarian cysts or fibroids|
|SIS||Identifies any blockage in the fallopian tubes|
If your GP has already performed any of these tests, it would be very helpful to bring copies of the results to your consultation as it may speed up your treatment and avoid unnecessary duplication. If you have been having fertility investigations or treatments elsewhere, it would also be helpful to bring copies of your notes with you.
1. Ovarian Reserve Tests -AMH
AMH blood level reflects the size of the remaining egg supply.
2. Sperm DNA Fragmentation Assay
Sperm consists of DNA, which is structured like a helical ladder. If this structure is distorted in any way, the sperm may not be able to fertilise the egg properly. A highly specialised sperm test can now analyse the proportion of abnormally structured sperm and tell if this is the reason for failed fertility treatments, particularly failed fertilisation in IVF cycles. There is increasing evidence to suggest that male fertility may disimprove with age. Previously, it was thought that only female reproduction ‘aged’.
3. Chicago Bloods
There are two main reasons for miscarriage; genetic factors and immune system factors. This test examines antibodies and auto antibodies in the blood to determine if a patient’s own immune system lies behind a failure to conceive or early pregnancy loss. The immune system can sometimes effectively ‘fight’ pregnancy. This test looks to see if the immune system is on a war footing. If it is, treatment can be given to reduce its power during the early weeks of pregnancy.
This test can be extremely expensive and will only be performed in exceptional circumstances, such as when successive IVF cycles have failed.
4. Endometrial Function Test (EET or Yale Biopsy)
Patients can now have their endometrium tested with the Endometrial Function Test (EFT). This patented test can optimise a patient’s chances of having a successful pregnancy by using molecular markers to assess the endometrium’s potential to support implantation and contribute to the developing embryo’s nutrition. Abnormalities in the process of implantation are believed to be the basis of many cases of unexplained infertility in women.
As with the Chicago Blood test, the Endomentrial Function Test is only performed in exceptional circumstances.