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Fertility Testing

Contents

Fertility Testing

The AMH Test (Ovarian Reserve)

When you’re born, you have a certain lifetime supply of eggs. The older you get, the more this supply slowly decreases in quality and quantity. The AMH blood test measures the mow many eggs you could potentially produce at any one particular stage in your life.

AMH test accuracy does come with some limitations, so please remember that the test isn’t 100% accurate — and it’s only one of many tools we use to gauge your fertility potential. 

Read more detail on the AMH test and what it means >>

Ovulation Problems

If your ovulation is irregular, or you’re not ovulating less at certain times, or not at all, it can impact your fertility. But it doesn’t mean pregnancy is impossible; you might just need medical intervention and management. There are three main types of ovulation problems.

What if I’m ovulating less?

  • Luteal phase defect:

When the luteal phase (the second half of the menstrual cycle after ovulation) is shorter than normal, it’s difficult for a fertilised egg to implant in the uterus.

What if my ovulation is irregular?

  • Irregular ovulation:

When your ovulation is inconsistent or it happens at irregular intervals, it could be caused by hormonal imbalances or underlying health issues.

What if I’m not ovulating at all?

  • Anovulation:

When you don’t ovulate at all, it could be due to hormonal imbalances, stress, excessive exercise, Polycystic Ovary Syndrome (PCOS), or other conditions.

Fertility Testing

Fibroids & Polyps

What’s the difference between fibroids and polyps?

Fibroids and polyps are both non-cancerous growths that can occur in your uterus. But while fibroids are smooth muscle, polyps consist of the thin endometrial tissue that lines the uterus.

How are fibroids and polyps diagnosed and treated?

Fibroids can be detected through pelvic exams, ultrasounds, and other imaging techniques. Whole polyps are often diagnosed through hysteroscopy, where a thin tube with a camera is inserted into the uterus, so the doctor can visualise and remove the polyps.

What causes fibroids and polyps?

 

  • Fibroids:
    The exact cause of fibroids is unknown, but they’re influenced by hormonal factors like oestrogen and progesterone. Genetic predisposition and family history also play a role; as do factors like obesity and the early onset of menstruation.
  • Polyps:
    The exact cause of uterine polyps is also not entirely clear. However, they are often associated with an imbalance of oestrogen and progesterone. Chronic inflammation of the uterine lining and certain genetic factors may contribute to their formation.
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Blocked Tubes

What are blocked fallopian tubes?

Blocked tubes occur when there’s an obstruction in one or both of the tubes that connect your ovaries to your uterus. These tubes are essential for transporting eggs from the ovaries to the uterus and providing a pathway for sperm to fertilise the egg.

How are blocked fallopian tubes diagnosed and treated?

Blocked fallopian tubes are often diagnosed through a combination of medical history, physical exams, imaging tests, and minimally invasive procedures like a hysterosalpingography (HSG) — where a contrast dye is injected into your uterus, and X-rays are taken to visualise your fallopian tubes.

In cases of mild blockage, fertility medications or minimally invasive procedures like laparoscopy might be considered to improve tube function. For severe or irreparable blockages, assisted reproductive technologies such as IVF can bypass the fallopian tubes and increase the chances of pregnancy.

What causes blocked tubes?

There are several potential causes, including:

  • Pelvic Inflammatory Disease (PID)
    Infections, usually caused by sexually transmitted infections (STIs), can lead to inflammation and scarring of the fallopian tubes.
  • Endometriosis:
    This condition involves the growth of tissue similar to the uterine lining outside the uterus. It can lead to adhesions and blockages in the fallopian tubes.
  • Previous Surgeries:
    Past abdominal or pelvic surgeries, such as surgeries for appendicitis or ectopic pregnancies, can result in scar tissue formation that blocks the tubes.
  • Ectopic Pregnancy:
    A pregnancy that occurs outside the uterus, often in the fallopian tube, can cause damage and blockages.
 

How do blocked tubes affect my fertility?



When the tubes are blocked, the egg and sperm can’t meet, making natural conception difficult. And if an egg is fertilised but can’t travel through the blocked tube to reach your uterus, it can lead to an ectopic pregnancy, which is a serious medical condition.

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Polycystic Ovary Syndrome (PCOS)

What is PCOS?

Polycystic Ovary Syndrome (PCOS) is a hormonal disorder that affects people with ovaries. It is characterised by a combination of symptoms, including irregular menstrual cycles, excess androgen (male hormone) levels, and the presence of small cysts on your ovaries (though not everyone with PCOS will develop ovarian cysts).

 

What causes PCOS?

The exact causes are still unclear, but it’s believed to involve a combination of genetic and environmental factors. Insulin resistance is also often associated with PCOS, which can lead to an overproduction of insulin, increasing your androgen levels and disrupting the normal menstrual cycle.

What are the common symptoms of PCOS?

The symptoms can vary from woman to woman — but most often it’s irregular or infrequent menstrual, or even a lack of periods altogether. This makes it a leading cause of infertility

How is PCOS diagnosed and treated?

Diagnosis typically involves a combination of physical exams, medical history, and lab tests to measure your hormone levels, including androgens and insulin. An ultrasound may be used to visualise your ovaries and check for cysts (though not everyone with cysts will have PCOS).

Treatment depends on your individual symptoms and goals. Lifestyle changes, like maintaining a healthy weight through diet and exercise, can help manage symptoms. Medical options include birth control pills to regulate your menstruation, and clomiphene to induce ovulation.

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Endometriosis

What is endometriosis?

It’s a chronic condition where tissue similar to the uterine lining grows outside your uterus, causing pain, menstrual irregularities, and potential blocked fallopian tubes.

Is IVF recommended if I have endometriosis?

Yes. Endometriosis can lead to pelvic scarring, tubal damage, and reduced egg quality, hindering natural conception. IVF bypasses these obstacles by directly fertilising eggs outside the body and transferring your resulting embryos into the uterus, increasing your chances of pregnancy.

“We don’t understand everything about endometriosis yet. Our treatment modalities have improved over time, but we still can't stop it recurring — only manage it”.
-Dr Erin Fuller

Male Fertility Testing

What causes male fertility issues?

Fertility issues aren’t limited to the female’s body, and it could be a problem with the male reproductive system, which might require a sperm count test — or a combination of both.

Here are the common male issues that male fertility testing is used to detect:

Low Sperm Count (Oligospermia)

Causes include hormonal Imbalances like a low level of testosterone, enlarged veins within the scrotum (a condition called varicocele), certain infections can lead to temporary or permanent damage to the testicles, lifestyle factors like smoking, excessive alcohol consumption, drug use, and obesity, and genetic factors.

Poor Sperm Motility (Asthenospermia)

Insufficient motility, or the inability to move fast, is another possible reason for infertility in men. Causes include abnormalities in the structure of the sperm tail, hormonal imbalances, and varicocele.

Misshapen Sperm (Teratospermia)

Causes include genetic abnormalities, environmental factors like exposure to toxins and radiation, and the negative effects on sperm health of certain medications.

Other than a sperm test, how do you detect male infertility issues?

Most often, the issue can be determined with a sperm count test, which is the most common fertility test for men. But sometimes, sperm counts aren’t enough — additional tests are needed, like hormone (blood) tests, scrotal ultrasound and genetic testing.

“With fertility issues, there can be an assumption that because it’s the woman trying for pregnancy, it must be her… But there could be a male fertility problem.”
-Dr Erin Fuller