FERTILITY TESTINGSana Javed

Amnah Mahroo

Sidrah Naseem

Fatima Darakhshan

Tehreem Tanveer

Misha Mazhar

Fertility Testing

Required when infertility is suspected: the biological inability of a person to contribute to conception

The state of a woman who is unable to carry a pregnancy to full term

Infertility

Female

Male

Female Infertility: Pathophysiology

Age Weight Genetic causes: Gonadal dysgenesis

(Turner syndrome) Hypothalamic-Pituitary disorders Anatomical disorders

Female Infertility: Pathophysiology

Infertility

Acquired/ Environmental problems

Age

Weight

Anatomical disorders

Ovulatory

Tubular

Cervical

Uterine

Pathophysiology: Ovulatory problems

Ovulatory

Hormonal

FSH & LH

Prolactin

Ovarian Factors

Anovulation

PCOS

Diminished Ovarian Reserve

Premature menopause Luteal dysfunction Ovarian cancer

Tubular Infertility

When fallopian tubes become damaged or blocked, they keep sperm from getting to the egg or close off the passage of the fertilized egg into the uterus.

Infection     

Abdominal Diseases      

Previous Surgeries     

Ectopic Pregnancy      

Congenital Defects

Pelvic causes

Pelvic causes include any disruption of the normal pelvic anatomy:

Scar tissue or "adhesions" Endometriosis Blocked, scarred, or distorted fallopian

tubes Benign tumors (fibroids) of the uterus

Cervical infertility

involves inability of the sperm to pass through the

mouth of the uterus due to damage of the cervix.

Causes: Inadequate or inhospitable cervical mucous Cervical narrowing or "stenosis" Infections of the cervix with common

sexually transmitted diseases \ Immune attack of sperm or "sperm allergy“

Uterine causes

Uterine causes include: Thin or abnormal uterine lining Anatomic problems

(polyps, uterine fibroids, abnormal shape of the uterus, septum or "dividing wall" within the uterus)

Unexplained Infertility

Difficulty in picking up the egg by fallopian tube Failure of implantation of the embryo into the uterus Failure of the sperm to fertilize the egg when in contact with each other

Behavioral Factors:  Diet and Exercise Smoking Alcohol Drugs

Environmental and Occupational Factors:  Lead Medical Treatments and Materials Ethylene Oxide Dibromochloropropane (DBCP)

Fertility Test For Women

Cervical Mucus Test

Cervical mucus becomes clear and stretchy

Allow sperm to survive in and travel through it.

The consistency of fertile mucous is akin to egg white.

Ovarian function tests To check functioning and

working of hormnes during your ovulation cycle.

Tests include Day 3 FSH Day 3 Estradiol blood tests to determine

the levels of inhibin B.

Post Coital test(PCT)

To determine: receptivity of cervical mucus ability of sperm to penetrate the cervical

mucus and to maintain activity volume of mucus is measured amount of mucus is determined ( scant, moderate, profuse ) Color and clarity is noted involves a bacterial screening.

Ultrasound tests

assess the thickness of the lining of the uterus (endometrium)

monitor follicle development to check the condition of the uterus and ovaries. maybe conducted two to three days later to

confirm that an egg has been released.

Hormone Tests

Hormone tests include the following: Luteinizing Hormone Follicle Stimulating Hormone Estradiol Progesterone Prolactin Free T3 Total Testosterone Free Testosterone DHEAS Androstenedione

Endometrial biopsy

Endometrial biopsy is a procedure in which a tissue sample is taken from the lining of the uterus and is checked under a microscope for any abnormal cells or signs of cancer

NORMAL RESULTS: The biopsy is normal if the cells in the sample have no abnormalities.

ABNORMAL RESULTS: Endometrial cancer or precancer (hyperplasia) Uterine fibroids Uterine polyps Infection Hormone imbalance

If the lining is being tested for infertility, the sample may determine if hormones are properly stimulating the lining so that the fertilized egg can implant.

Laparoscopy

This is a procedure done under general anesthesia, that involves the use of a narrow fiber optic telescope

The laparoscope is inserted into a woman’s abdomen to provide a view of the uterus, fallopian tubes, and ovaries

If any abnormalities such as endometriosis, scar tissue or other adhesions are found, they can be removed by a laser

Hysteroscopy

A narrow instrument called hysteroscope is inserted into the uterus enabling the doctor to examine it.

There are two types of hysteroscopy. Diagnostic hysteroscopy is used to detect any problems inside a woman's uterus. Operative hysteroscopy is used to help perform surgical procedures

What Can Hysteroscopy Detect?Diagnostic hysteroscopy can be used to detect a number of uterine abnormalities that may be contributing to infertility. These abnormalities include: 

uterine fibroids uterine adhesions uterine cysts septate uterus 

Hysterosalpingogram

A hysterosalpingogram (HSG) is an X-ray test that looks at the inside of the uterus and fallopian tubes and the area around them.

PROCEDURE:

A dye is put through a thin tube into the uterus.

The dye will flow into the fallopian tubes because the uterus and the fallopian tubes are hooked together.

Pictures are taken using a steady beam of X-ray (fluoroscopy) as the dye passes through the uterus and fallopian tubes.

The pictures can show problems such as an injury or abnormal structure of the uterus or fallopian tubes, or a blockage in the fallopian tube.

Complete absence of sperm (azoospermia) Low sperm count (oligospermia) Abnormal sperm shape (teratozoospermia) Problems with sperm movement (asthenozoospermia) Sperm that is completely immobile (necrozoospermia); the

sperm may be alive and not moving, or they may be dead Problems with sperm delivery, due to sexual dysfunction,

an obstruction, previous vasectomy, or retrograde ejaculation

Problems with erections or other sexual problems

Male Infertility: Pathophysiology

Diagnosing male infertility problems usually involves: General physical examination and medical history Examination Questioning about any inherited conditions chronic health problems illnesses injuries or surgeries that could affect fertility.Semen analysis Semen is generally obtained sent to a laboratory to analyse signs of problems such as infections

Male Infertility Tests

1. Scrotal ultrasound

2. Transrectal ultrasound.

3. Hormone testing

Additional tests

Post-ejaculation urinalysis

Genetic tests

Testicular biopsy

Anti-sperm antibody tests