Treatment Options
WOMEN Fertility Testing
Baseline investigations
85% of couples will achieve a pregnancy within the first year of unprotected intercourse. The likelihood of pregnancy decreases significantly after the first year, and markedly so if the female partner is over 35 years old. Over this age couples are encouraged to seek advise after 6 months of unprotected intercourse.
The first step in the evaluation of patients with sub fertility is to assess the couple to determine their fertility potential and possible reasons for their difficulty in conceiving.
Our clinic: Oasis Fertility Centre offers a whole range of Fertility Testing in Calgary – everything from basic fertility testing to advanced fertility treatments like in vitro fertilization (IVF). We guide you through and help you analyse as to where to begin.
Ovarian Reserve For Fertility Testing
An average woman will have approximately 6-7 million immature eggs at 20 weeks in their mothers womb at 16-20 weeks pregnancy. There is a massive loss of eggs in the second half of the pregnancy, such that at the time of birth there are approximately 500,000 – 2 million eggs left. The egg count declines further by puberty. Of these, for the next 40 years or so, approximately 400-500 eggs will ovulate over the woman’s life.
Ovarian reserve testing involves assessing the number of eggs remaining in the ovaries. This measure will help guide the type of treatment that is recommended. Ovarian reserve testing is a 2 part process. The first involves blood work to evaluate the hormones, and a vaginal ultrasound scan performed to count the number of follicles in the ovary (antral follicle count, or AFC). Both are performed in the first week of the cycle. At the time of the ultrasound scan, a sonohysterogram will also be performed to assess the uterine cavity, as the embryo will only grow in a normal uterus.
In keeping with the women fertility test in Calgary and our personalized approach to treatment, the ultrasound scans are performed at Oasis Fertility Centre.
Blood Test For Fertility Testing
Blood testing is done twice during the cycle to check ovarian reserve, fallopian tube potency, uterine cavity, and sperm health.
Additional tests may be needed depending on the results of these investigations.
Furthermore, routine blood tests are performed to determine exposure to sexually transmitted diseases (STD).
The requisitions for the blood tests will be uploaded to your portal. Please take these to your nearest Alberta Precision Labs facility. These tests need to be performed between days F2-5 of your cycle. Day 1 of your cycle is considered as the day of proper flow. If the period starts before 3 PM, the same day is considered as day 1. And if it start after 3 PM, we regard the next day as day 1.
On day 1 of your cycle, please write to “Nursing Team” using your patient portal to make an appointment for the ultrasound scan.
You will be scheduled for the scan in the first week of your cycle as above.
Transvaginal Scan For Fertility Testing
Transvaginal ultrasound imaging is one of the most vital steps in our fertility testing performed for your initial investigation and monitoring of your treatment as it allows for more accurate visualization of the ovaries and uterus. The procedure is frequently performed during your menstrual cycle, and generally takes approximately 15 minutes to perform.
During the procedure the vaginal ultrasound probe, covered by a sterile probe cover is inserted into the vagina. The procedure is relatively painless. It is important that your bladder is empty as a full bladder precludes adequate views. You will be asked to empty your bladder just before the scan. The procedure is time sensitive and is usually performed at particular time points during your menstrual cycle. It is important that you message the nursing team through the web portal to book the ultrasound.
There are no complications associated with the procedure, though some women with a history of painful intercourse and pelvic pain may experience slight discomfort. Should you have any concerns or questions, please don’t hesitate to reach out to the nursing team.
Sonohysterogram, Hysterogram (also referred to as saline instillation sonogram – SIS)
This procedure is performed to evaluate the uterine cavity. It is considered as a screening investigation to determine the normalcy of the uterus.
Procedure for fertility test in women:
As a part of women fertility test, a speculum examination is performed to visualize the cervix. Once the cervix comes into view, a thin tube (catheter) is inserted into the uterine cavity, and the speculum is withdrawn. This is usually the most
uncomfortable part of the process.
Transvaginal ultrasound is then performed, and the uterus visualized. Normal saline is then injected slowly while the uterine cavity is examined. Any presence of any abnormalities in the uterus, such as fibroids or polyps are noted. The presence or absence of fluid in the pelvis may secondarily provide evidence of tubal patency.
The examination takes approximately 10 minutes to perform and is associated with minor discomfort, which may be more pronounced in patients with chronic pelvic pain and endometriosis.
Sonohysterogram is performed in the first week of the cycle once the period has ended.
Please follow the instructions for transvaginal ultrasound to book the procedure.
MEN Fertility Testing
Blood test
Blood testing for men is typically for hormone levels.
Additional tests may be needed depending on the results of these investigations.
Furthermore, routine blood tests are performed to determine exposure to sexually transmitted diseases (STD).
The requisitions for the blood tests will be uploaded to your portal. Please take these to your nearest Alberta Precision Labs facility.
Once the results are in, your consultation appointment with the specialist at Oasis Fertility Centre will be arranged.
Sperm Function Assessment
Couples can have many, very different reasons for their infertility, and they can be as individual as the couples are. Combined factor infertility has been found in 40% of couples, so the male partner needs to be tested even if a reason for infertility has been found in the female partner. But a routine semen analysis (such as might be done by a pathology lab) only gives the doctor information about the number of sperm present, how many of them are moving, and how many have normal shape.
Therefore, a basic semen analysis does not, provide any information about other factors that might be interfering with fertility, or how the sperm in the sample will behave when prepared for infertility treatment.
In other words, it provides little information on the functional potential of his sperm. In order for fertilization to occur after intercourse, sperm must first leave the vagina and travel through the mucus within the cervix into the uterus, and then make their way to the fallopian tubes, where they will hopefully meet an egg soon after it has been ovulated.
Many things can interfere with this process and cause infertility, and the Sperm Function Assessment (or “SFA”) is a series of tests that go far beyond a basic semen analysis to provide the doctor with information which helps decide which treatments might, or might not, be appropriate for you.
Over the long term this saves time (and money) being wasted on treatments that would probably not work.
What does the SFA include?
The male partner will need to produce a semen sample at the Oasis laboratory. The sample will immediately be placed under ideal storage conditions and properly assessed for its “liquefaction”, which is a normal process the semen undergoes soon after ejaculation. The SFA investigation includes the following tests.
A comprehensive sample analysis
This includes the volume and pH of the semen, the number of sperm, how many of the sperm are moving and the quality of their movement. It also includes not just the % of sperm with normal shape but also other information about the types of abnormal sperm that are present.
The laboratory will also calculate the “Teratozoospermia Index” (or “TZI”), which describes the severity of abnormal sperm morphology, and helps the doctor determine which fertility treatments might not be beneficial for you as a couple.
The sample will be also assessed for unusual amounts of debris, suspected presence of bacteria, clumping of the sperm and for the presence of cells other than the sperm.
A screen for possible infection
The semen sample will also be screened for the presence of leucocytes (white blood cells), and their approximate concentration in the sample.
This information will indicate to the doctor whether an infection might be present, and this could be investigated further by semen or urethral cultures or by referral to a urologist.
A screen for anti-sperm antibodies
A man can sometimes produce antibodies against his own sperm which bind to his sperm (there is a variety of possible causes for the formation of these antibodies).
These antibodies can interfere with the movement of sperm through the female reproductive tract and/or interfere with the sperm’s ability to fertilize the egg.
The formation of anti-sperm antibodies cannot be stopped, but the results of this testing can provide the doctor with information about which treatments might be suitable to bypass those stages of the sperm’s journey where the antibodies can interfere with fertility.
A “Trial Wash” of the semen sample
If sperm are going to be used for infertility treatment they must be “washed” in order to separate the best sperm from the rest of the semen.
While our standard sperm washing procedure works well for most men, it might not work well for some.
Therefore, a trial wash of your semen is required in order to make sure that the standard wash procedure can be expected to work for you on the day of treatment.
If the trial wash does not work well the laboratory might be able to adjust it and wash the sperm differently.
Some semen samples can also only give washed preparations that have very low sperm counts or very low motility.
A trial wash therefore gives the laboratory valuable information as to how best to prepare your sample, and also how many washed sperm they can expect to obtain on the day of treatment.
An assessment of suitability for IUI or ICSI
The laboratory will provide the doctor with a summary of information about the semen sample and the quantity and quality of the sperm that it contains.
The report will also indicate whether or not the sample quality meets the minimum requirements for use in IUI or whether ICSI should be considered. Because there might be other medical information that the laboratory is not aware of, this can only be a recommendation, and the ultimate decision about treatment will be between your doctor and you (and your partner).
DNA Fragmentation Index
We at Oasis Fertility Centre, have the provision of DNA fragmentation test for sperm as one of the major parts of male fertility test in Calgary. It is a laboratory test that measures the amount of broken DNA in a man’s sperm. High levels of DNA fragmentation can affect the chances of a successful pregnancy. Many studies show that there is a link between sperm DNA damage, infertility and miscarriage.
Men who are fertile tend to have less sperm DNA damage. Men who are infertile tend to have high levels of damage and abnormal semen analyses.
The test is typically performed on a semen sample and can be done in conjunction with other fertility tests such as a semen analysis. The test results are usually reported as a percentage – DNA Fragmentation Index (DFI) which indicates the percentage of sperm cells containing measurable DNA damage. Higher numbers indicate a greater amount of DNA fragmentation.
Several tests have been developed to assess sperm DNA damage. The most frequently used is the DNA Integrity Assay in our male fertility test.
There are several causes of high DNA fragmentation in sperm, including varicocele, infection, radiation or chemical exposure, and certain genetic conditions. Men with high DNA fragmentation may be advised to undergo additional testing and/or treatment to address the underlying cause.
It is important to note that the DNA fragmentation test is not a diagnostic test and isused in conjunction with other diagnostic tools to evaluate male fertility. Men with high DNA fragmentation may still be able to father a child through assisted reproductive techniques such as IVF with ICSI.
Plan a systematic journey to your pregnancy and parenthood with our versatile Fertility Testing at Oasis Fertility Centre.
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