The fertility tests you will be required to have, will depend on the complexity of you fertility problem. We will not repeat any tests you have had so long as the results are valid. Basic investigations include semen analysis, ovarian function and tubal patency.

Semen Analysis: There are minimum criteria for normal sperm parameters to stand a good chance to achieve a pregnancy naturally or through simple procedures e.g. OI, TSI or IUI. A normal assessment according to the WHO:

• Semen volume - 2-4mls

• Sperm count - more than 20 million per ml

• Sperm motility - more than 50% moving

• Sperm morphology - more than 30% of normal shape

MAR test to check for anti-sperm antibodies in the semen is very important as the antibodies can attach to the sperm and cripple them. The semen sample is obtained by masturbation or collected from a special condom following intercourse. Sterile containers must be used to collect the sample following three days of sexual abstinence.

Ovarian Reserve: We can assess ovarian reserve through various blood tests. Classically we check FSH, LH, Oestradiol (E2) and prolactin between day 1 and 3 of the cycle. Day 1 of your cycle is the first day you have bleedin per vagina ( spotting does not count). We found that checking you Anti-Mullerian Hormone (AMH) level at any day of the cycle is more accurate than the other blood tests.

Ultrasound Scan: Vaginal scan adds an extra dimension to assessing your ovarian reserve by counting the number of antral follicles (potential eggs) in each ovary. In addition it gives us the chance to assess the lining of your womb (endometrium) and exclude other pelvic pathology e.g. fibroids, endometriosis, ….etc.

Tubal Patency Tests: We can check the patency by one of three methods; the choice will depend on your circumstances:
1-  Laparoscopy and dye test: we look inside your tummy down the telescope and inject blue dye through the neck of the womb. We can also exclude or deal with pelvic adhesions, endometriosis and other pelvic pathology.
2-  HSG: an X ray while injecting a radio-opaque dye through the neck of your womb.
3-  Saline instillation sonography (SIS): Vaginal ultrasound scan during injection of saline or special media (Echovist).
Hysteroscopy: In special circumstances we recommend examining the lining of your womb up the telescope to ensure that it is favourable for the embryos to implant.