Fertility assessment

This page describes the fertility assessments and other tests you need to have before you can start a cycle of IVF treatment. These include semen analysis, ovarian assessment, and a set of virology tests that are required prior to treatment.

Semen analysis

If you’re providing sperm for any kind of fertility treatment, a sample will be analysed first. If you’ve had a recent assessment elsewhere, our embryologists will look at the results and decide whether another should be done. Fertility can change, even if you have already fathered a child. This may be due to illness, a change in lifestyle or age.

The reason you’re asked to provide a semen sample could be any of the following:

• Assessing the likelihood of achieving a pregnancy with your partner.
• Diagnosing a sperm problem that means you may need medical help to achieve a pregnancy.
• Determining which treatment is the most appropriate for you and your partner.
• For storing semen, whether as a back-up for treatment, for preserving your fertility, or before a vasectomy.

All our semen analyses are performed using World Health Organisation (2010) Guidelines. We assess:

• Sperm count – how many sperm are present in each millilitre of semen
• Motility – how well the sperm are moving
• Morphology – how many sperm are of normal size and shape
• The sample’s volume and pH.

Results

You’ll usually get the results through the post, normally to your home address, and will be discussed in-depth at your Initial Consultation appointment. You will be advised of what the analysis shows, how it might affect your treatment and the method of treatment that is appropriate for you.

Ovarian assessment

This helps us to decide the best option of fertility treatment for you. A blood test is taken and analysed for Anti-Mullerian Hormone (AMH), which helps us to assess your potential reaction to stimulating drugs, and predict how many eggs we might be able to collect. This assessment also includes a trans-vaginal ultrasound, done at any stage of your menstrual cycle which enables us to look closely and identify:

• The volume of your ovaries – Ovaries tend to decrease in size in the time before the menopause. Smaller ovaries are linked with a poor response to IVF stimulation drugs.
• Your Antral Follicle Count – This test is a good predictor of how your ovaries will respond to the stimulation drugs. It can give us a good idea of how many eggs might be collected, although the count can vary between your cycles.

Anti-Mullerian Hormone (AMH)

This hormone is produced by the supporting cells around the eggs in the ovary and is the best single indicator of responses to fertility drugs. As you age and the number of eggs in your ovaries falls, we see a decrease in the level of AMH in your blood. Measuring it is a good way to get an indication of your ovarian reserve (link to A-Z) and AMH levels fall rapidly after the age of about 40. The levels of AMH in the blood don’t change across your cycle, so we can do this test on any day.

Virology

Before treatment, you also need to have a set of virology screening results. You can use recent test results if you have them. Some of the results will need to be dated within the 3 months before starting treatment if it’s your first cycle. For subsequent cycles, they need to be dated within the last 2 years.

Tests include: