Problems in men can be due to suboptimal sperm production, hormonal problems, issues with passage of semen through the reproductive tract or genetic problems. The following tests may therefore be required:
• Semen analysis. Semen analysis involves collection of the semen and analysing it using special methods. We are able to assess the number of sperms, the motility and morphology of sperms using computerized techniques.
• Hormone testing. Blood tests are done to assess the level of sexual hormones as well as to rule out endocrine problems such as thyroid disorders.
• Ultrasound. Ultrasound may be used to screen for abnormalities in the scrotum and testes as well as to detect problems such as retrograde ejaculation.
• Genetic testing. Genetic testing may be done to determine whether there's a genetic defect causing infertility.
• Testicular biopsy. In this test, a small sample from the testis is obtained with a needle and studied under a microscope.
Women with infertility may have problems with the ovaries, hormones, uterus, fallopian tubes or the cervix. A through gynaecological physical examination is done. Several additional tests may be required. Some of the common tests are listed below. Any one patient does not require all the tests. The tests are advised based on the clinical scenario in a stepwise manner. This requires patience on the part of the patient as well as the physician so that so that unnecessary testing with low yield tests may be avoided.
• Ovulation testing. Blood tests that detect female hormones can be used to find out if the ovaries in the woman are releasing eggs during the menstrual cycle.
• Hysterosalpingography. This involves a set of X-rays taken of the reproductive tract after injecting a dye into the uterus. It is useful in delineating the cavity of the reproductive tract and identifying blocakges.
• Ultrasound. Ultrasound is an extension of routine gynaecological evaluation in many cases. It can be used to identify anomalies of the ovary, fallopian tubes and the uterus. High resolution 4-D ultrasonography which is routinely done at our centre provides excellent detail.
• Hormone testing. Apart from reproductive hormones, thyroid hormone level and levels of pituitary hormones may need to be assessed.
• Hysteroscopy. Hysteroscopy may be required in some women to visualize the inside of the uterine cavity. Please refer to our section on hysteroscopy to learn more.
• Laparoscopy. Laparoscopy may be required to identify endometriosis, scarring, blockages or irregularities of the fallopian tubes, and problems with the ovaries and uterus.
• Genetic testing. Genetic testing helps determine whether there's a genetic defect causing infertility.