IVF Diagnostic tests
IVF Diagnostic test

Do I need an IVF diagnostic test?

When you are experiencing fertility issues and IVF diagnostic test, several tests may be needed before starting treatment. These are designed to help us reach an accurate fertility diagnosis and design a personalised treatment plan for you. We are looking at key areas including:

  • Are you ovulating normally?
  • Are your Fallopian tubes functioning?
  • Are your partner’s sperm normal and functional?

We will carry out IVF diagnostic test to determine ovarian reserve and to analyse sperm health and viability. You will also have some basic health checks such as your Body Mass Index and blood pressure, and we will carry out a pelvic ultrasound scan.

When you have experienced recurrent miscarriage, or you’ve had unsuccessful IVF treatment, then it’s likely that you will need more sophisticated diagnostic testing. Our personalised approach to your testing means we make sure that we give you the most appropriate tests, designed to save you time and expense but, most importantly, delivering accurate results which will help us give you the most appropriate treatment plan for your own individual needs.

Female IVF Diagnostic test ?

Endometrial Receptivity Analysis (ERA)

Endometrial receptivity analysis (ERA) is a way of finding out when the lining of the womb – known as the endometrium – is most receptive. This helps us to decide a time for your embryo transfer that’s most likely to result in success.  

Could ERA be right for me?

Embryo transfer is one of the most important stages of your IVF treatment. Sometimes, though, the embryo won’t implant, and this could be because of a problem with the endometrium.

If we think this could be an issue for you, we might suggest endometrial receptivity analysis. If you’re still unsure whether it might be an option, talk to your local clinic or contact us for support. ERA is a relatively new test so we are still gathering information on its effectiveness.

What does ERA involve?

We can carry out ERA testing either during your natural cycle, or during a cycle prompted by medication.

During the test, which is similar to a smear, we’ll take a biopsy of the womb lining then analyse the tissue to determine when your endometrium will be most receptive – we call this the window of implantation. We can then use these findings to determine the timing of your embryo transfer, which could increase the chance of successful implantation.

Hormone screening

Hormone screening and testing can give us an indication of everything from how many eggs you’re able to produce, to whether you might have an underlying medical condition – and all of this information will help us to give you the right fertility treatment. 

Could testing my hormones be for me?

If you’re a new patient or suffering from unexplained fertility problems we’re likely to suggest hormone screening, as it can really help us to better understand your needs.

In women, we can use hormone screening to explore possible causes of irregular cycles and check your ovarian reserves, which helps us to understand how many eggs you might be able to produce during treatment. In men, particular hormones can be good indicators of how much sperm you’re able to produce.

What does hormone screening involve?

Almost all hormone screenings involve a simple blood test. Depending on what we’re looking to find out, there are a number of things we might be checking for.

Ovarian reserve
To get an indication of your ovarian reserves, we’ll analyse your levels of antimullerian hormone (AMH) and/or do an antral follicle count (AFC), which involves a simple ultrasound scan. We might also look at your levels of follicle stimulating hormone (FSH) as a measure of ovarian reserve.

Irregular cycles
There are lots of reasons why your cycle might be a little irregular, and it could be caused by hormones. We can check for prolactin, androgens, and thyroxine – which is produced by the thyroid – to see whether they could be part of the problem.

Pelvic ultrasound

The pre-treatment pelvic ultrasound helps us to plan your treatment. This type of ultrasound, also known as a 3D trans-vaginal pelvic ultrasound scan, helps us to get a much clearer picture of your womb, ovaries, and pelvis. We also use it to check the quality of your womb lining – the endometrium – and to calculate the dosage of drugs you might need for IVF treatment.

Could a pelvic ultrasound be for me?

Taking a closer look at your womb, ovaries, and pelvis allows us to look for any problems or conditions as well as decide how much medication you might need to produce the right number of eggs for treatment.

There’s a lot we can find out using a pre-treatment ultrasound scan, so we’re likely to recommend it to most patients considering IVF or ICSI.

What does a pelvic ultrasound involve?

Ultrasound is an imaging technique that uses high frequency sound waves to get pictures of the inside of the body without using X-rays. For this type of ultrasound scan we use a specially designed ultrasound probe, which is gently inserted into the vagina in a safe, short, and painless procedure. We then move the ultrasound probe into different positions to clearly visualise the uterus and ovaries.

By doing a trans-vaginal scan, we’re able to get the probe closer to the pelvic organs to get a better picture – meaning we can get a much better idea of your needs.

Recurrent implantation failure screening

There can be many reasons behind recurrent miscarriages or implantation failures.

If you’ve experienced a miscarriage or implantation failure, there are many tests we can offer depending on your individual circumstances. Depending on what we discover, we can offer you different treatments to then increase your chances of successful implantation. 

If you would like more information on any of these tests and to find out if they are suitable for you, you will be able to discuss with your doctor at your consultation. We also have detailed Patient Information documents on all of our tests and treatments.

Male IVF diagnostic tests

Male fertility problems can be due to a number of issues and diagnosis usually involves a general physical examination and semen analysis. We can offer cutting edge male diagnostic tests too, which check for chromosomal issues, or sperm DNA damage. 

You can read more about these tests below.

Hormone screening and ivf diagnostic tests

Hormone screening and testing, also sometimes known as a male hormone profile test, can give us an indication of everything from how many sperm you’re able to produce, to whether you might have an underlying medical condition – and all of this information will help us to give you the right fertility treatment.

Could testing my hormones be for me?

In men, particular hormones can be good indicators of how much sperm you’re able to produce.

If you’re a new patient or suffering from unexplained fertility problems we’re likely to suggest hormone screening, as it can really help us to better understand your needs. Following these tests we will be able to recommend the best fertility treatment for you. If able to use your own sperm this is likely to be:

  • IUI 
    • Intrauterine Insemination (IUI) simply means putting prepared sperm into the uterus. It has been more commonly known as artificial insemination.
  • IVF
    • In vitro fertilisation (IVF) is a method of fertilising an egg by placing it with a specially-prepared sperm sample.
  • ICSI 
    • Intracytoplasmic sperm injection (ICSI) is a laboratory procedure carried out during fertility  treatment where an individual sperm is injected directly into an egg.

What does hormone screening involve?

The levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) in your blood can help us get an idea of how much sperm you might be producing. We’ll also check your testosterone levels.

Virology Screening and ivf diagnostic tests

Virology Screening is required of all our patients who are planning on using their own sperm in their fertility treatment. This important first step is where we check for viral infections, such as Hepatitis B, Hepatitis C and HIV, which you may not be aware you have but could impact your fertility and your treatment. Knowing if you have any of these viral infections will allow us to advise you on what steps, if any, need to be taken before starting treatment.

What does virology screening involve?

The virology screening is a relatively quick and painless step at the start of the fertility treatment process. We check for viral infections by taking a small blood sample for testing.

Semen analysis

The quality of your sperm is really important in deciding your next steps.

What is semen analysis?

Semen analysis is the process where we analyse a sample of your semen using various techniques and equipment  to determine the quality of your sperm. 

How can semen analysis help me?

Male fertility problems are one of the largest known causes of infertility in couples – in fact, they contribute to up to 30%–50% of cases. Sperm analysis is essential to both diagnosis and treatment, so when you come to us, your sperm is one of the first things we’ll need to check.

Could semen analysis be right for me?

Whether or not you’re generally healthy or have had a child before, we’ll always recommend semen analysis to every man that comes to CARE. When couples are struggling to start a family around 30% of cases are related to sperm, so it’s essential we see whether this is a possibility.

We’d usually book you in for semen analysis before your first consultation or as part of a fertility assessment. That way, the results will be ready when you meet your consultant.

How to prepare for semen analysis

Before the sperm test, you’ll need to abstain from sex for three to five days. Ideally also avoid, alcohol, majuiana and any herbal remedies such as St John’s Wort.

What does semen analysis involve?

Before the sperm test, you’ll need to abstain from sex for three to five days. When we test your semen sample, we’ll assess:

  • Ejaculate volume 
  • Sperm concentration (number) 
  • Sperm motility (how well they’re swimming)
  • Sperm morphology (their shape, size, and appearance)
  • Presence of white or red blood cells
  • Whether there’s an immune response, known as anti-sperm antibodies, against sperm proteins

Multiple Ejaculation Resuspension and Centrifugation (MERC) test

MERC lets us detect sperm in semen samples even when numbers are low.

Our scientists introduced the MERC technique so that, when our patients have a low sperm count or reportedly no sperm, we can try to find sperm in multiple semen samples to use in fertility treatment and avoid the need for surgery.

Could MERC be right for me?

If you’ve been told you’re producing little or no sperm (azoospermia) in your ejaculate, we could recommend MERC as a way of collecting sperm for treatment. If it’s not successful, you might be recommended to consider surgical sperm retrieval.

What does MERC involve?

For the MERC test, we’ll need you to provide us with several semen samples in one day – usually around three samples with two hours left between each.

Once you’ve given us the samples, we’ll process them, finding any sperm that could be used in fertility treatment. If we identify sperm in your samples, we might then freeze them to use in future treatments.

Sperm chromosome screening

Genetically testing your sperm can help us better decide your next steps.

Research suggests that low sperm motility, low sperm count and poor sperm shape could be related to chromosomal disorders. Screening your sperm lets us check for these kinds of anomalies and whether they could be passed on to an embryo.

Could sperm chromosome screening be right for me?

Problems with your sperm chromosomes can cause miscarriages or serious genetic conditions and illnesses in children, so if we think your sperm might have any chromosome disorders we’ll encourage you to be tested.

We’ll usually recommend sperm chromosome screening as an additional male fertility test for:

  • Couples with repeated miscarriages or implantation failure
  • Couples with previously low or failed fertilisation following IVF
  • Men who have normal chromosome patterns but whose embryos have chromosomal problems
  • Men with a low sperm count
  • Men over 50.

What does sperm screening involve?

For screening, we simply need you to provide a semen sample. We’ll then freeze your sample and test it for abnormalities, and results should be available within a few weeks. Once we have the results, together we’ll discuss your next steps, which could be further tests or possible treatments.

SOS (Sperm Oxidative Stress) test

High levels of oxidative stress could be a cause of lower pregnancy rates and a higher risk of miscarriage.

Excess oxidative stress in the body has been linked to abnormal sperm morphology and motility, as well as sperm DNA and cell membrane damage, contributing to poor sperm function, abnormal semen analysis results, and failed IVF outcomes. DNA damage within sperm cells could result in DNA errors within an embryo, in turn potentially contributing to lower pregnancy rates and a higher risk of miscarriage.

What is oxidative stress?

Highly reactive molecules called free radicals are produced as a by-product of our cells using oxygen to produce energy, and though these free radicals usually perform vital functions for our health, such as fighting infection, too many can be very damaging. Antioxidants produced by the body counteract these free radicals, keeping the system in balance, but when the production of free radicals exceeds the body’s production of antioxidants, the excess free radicals can cause damage to tissues such as proteins, cell membranes and the DNA of cells, including sperm. This is called oxidative stress.

Who should be tested for oxidative stress?

We may recommend a SOS (Sperm Oxidative Stress) test as an additional male fertility test for:

  • Partners of women with a history of two or more pregnancy losses
  • Males over the age of 40
  • Males with suboptimal semen analysis results (particularly low morphology or motility)
  • Males with poor lifestyle, body mass index over 30, who smoke, have high alcohol intake or poor diet.

What does the SOS test involve?

For SOS screening, we simply need you to provide a semen sample. We’ll then analyse the sample in our laboratory, assessing the balance of free radicals and antioxidants in the sperm. This test can be done at the same time as a semen analysis test, or at any point in your treatment. Once we have the results, we’ll discuss your best next steps with you, which could be further tests or possible treatments.

Sperm DNA damage screening

Sperm DNA damage could be a cause of low quality sperm. DNA is the genetic material required to be shared with an egg for a healthy embryo to develop. If this genetic material is damaged, leading to what is called DNA fragmentation, there is a higher likelihood of unexplained infertility, miscarriage, and unsuccessful IVF cycles. 

Many factors relating to age and lifestyle can damage your sperm’s DNA, including scrotal heat exposure, varicocele (enlarged veins around the testicles), chronic infections, poor diet, stress and alcohol. So, if you’re over 50 years, are a current or ex-smoker, or if you could have been exposed to glue vapours or other toxicants, or any of the other factors that can affect your fertility, it might be a good idea to have your sperm checked for DNA damage.

Could sperm DNA screening be right for me?

We’re most likely to recommend sperm DNA damage screening if you’re struggling with:

  • Unexplained or persistent infertility
  • Low fertilisation rates or poor embryo quality in IVF cycles
  • Recurrent implantation failure
  • Recurrent miscarriage

What does sperm DNA screening involve?

For screening, we simply need you to provide a semen sample. We’ll then freeze your sample and ship this over to our laboratory, where it will be thawed and tested for DNA damage.
Once we have the results, together we’ll discuss your next steps, which could be further tests or possible treatments.

HFEA Comment

Are the treatments safe and effective?

The independent regulator of fertility treatment, the Human Fertilisation and Embryology Authority (HFEA), has developed a ‘red-amber-green’ rating system and provides information on their website about treatments that are offered on top of your routine fertility treatment – known as treatment add-ons. They consider that the only way to be confident that a treatment is effective enough to be used routinely is to carry out a randomised controlled trial (RCT). In an RCT, patients are assigned randomly to two groups: a treatment group, given the new treatment and a control group, given a well-tried treatment or a placebo.

There is some evidence for a relationship between sperm DNA damage and the outcome of fertility treatment. However, the evidence is conflicting and depends on the type of test used. The HFEA do not currently give a traffic light rating for treatments relating to sperm DNA damage.

Sperm DNA damage testing is a non-invasive procedure performed on a semen sample, usually before treatment as an additional diagnostic test. There are no significant additional risks to the patient

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