What tests are done for infertility?

Written by Zhao Min Ying
Reproductive Medicine
Updated on October 24, 2024
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Couples who have lived together for more than a year and have regular sexual intercourse without using any contraception and still have not conceived are diagnosed with infertility. For men, it is referred to as sterility. Infertility requires couples to visit the reproductive medicine department for relevant infertility tests. The tests for men are simpler, primarily requiring abstinence from sexual activity for two to seven days before undergoing a semen analysis. For women, the tests vary depending on the condition but generally include the following aspects: First, blood tests related to endocrinology are conducted 2 to 4 days into menstruation. Second, from 3 to 7 days after menstruation ends, during which sexual intercourse should be avoided, tests can be conducted to check the patency of the fallopian tubes. Third, ovulation can be monitored by ultrasound from days 9 to 11 of the menstrual cycle until ovulation is confirmed. Additionally, routine gynecological examinations, including checks of the cervix and ultrasound examinations, are also conducted.

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Will taking too much emergency contraception lead to infertility?

Taking emergency contraceptive pills excessively may lead to infertility. Emergency contraceptives contain highly effective hormonal ingredients, mainly working by altering the viscosity of cervical mucus and affecting the implantation of fertilized eggs. Emergency contraceptive pills can cause menstrual irregularities and disorders, leading to irregular vaginal bleeding. Some may also affect ovulation and the motility of the fallopian tubes, while also causing symptoms such as breast tenderness, nausea, and vomiting. Excessive use of emergency contraceptive pills can significantly affect the endocrine system, potentially leading to infertility and, in some cases, ectopic pregnancy. Therefore, emergency contraceptives should not be used as a regular method of contraception.

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Can immunological infertility be treated?

Immunological infertility is treatable. There are several main methods for treating immunological infertility. The first method is the blocking therapy, which involves using condoms for 3-6 months to make the sperm antigen antibodies disappear, thereby increasing the conception rate through alternate day intercourse. Many women are able to conceive through this method. The second method is in vitro fertilization, which is chosen if there is a high density of antisperm antibodies in the woman's body, making in vitro fertilization necessary for conception. This method generally has a high success rate. The third method is intrauterine artificial insemination. When there are many antisperm antibodies in the woman’s cervical mucus, this method involves treating the male’s semen outside the body, selecting high-quality sperm for artificial insemination. The fourth method is immunosuppressive therapy, which primarily involves the use of corticosteroids. However, the use of these hormones often causes some adverse damage to the body.

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What is infertility?

If a couple has been married for a year without using contraception, are not living separately, and have not conceived, or if there has been a history of abortion and no conception has occurred within six months of unprotected sexual activity, then this is considered infertility. Infertility can be due to female factors or male factors, with male infertility also accounting for a significant proportion. Male investigations are relatively simple, non-invasive, and also less expensive, so it is generally advisable to first conduct male tests, followed by female assessments, such as endocrine function, ovulation, uterine lining, fallopian tube examinations, or various biochemical tests, etc.

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Do you test for TPPA for infertility?

TPPA testing is a diagnostic test for syphilis, used in cases of infertility. Typically, general hospitals do not include syphilis testing. If there is a high risk of syphilis, such as if either partner has a history of unprotected sexual intercourse, or if syphilis is suspected during pre-marital, prenatal, or pre-pregnancy examinations finding TP positive, a request can be made for TPPA testing. Diagnosis of syphilis requires both TPPA and RPR titers; the condition is assessed based on these two indicators.

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Precautions for Infertility Examination

Infertility examinations primarily involve tests for both men and women. For men, the examination includes a semen analysis which requires abstinence for 2-7 days. Semen should be collected through masturbation, using a specialized semen collection cup provided by the laboratory. Ordinary condoms should not be used for semen collection. After collection, the semen must be kept warm and promptly delivered back to the laboratory. For women, the examinations include several aspects. First, during the menstrual period, blood is drawn on an empty stomach between the 2nd and 4th days to check hormone levels, and an ultrasound is used to assess the baseline state of the ovaries. Second, between the 3rd and 7th days after the menstrual period ends, when sexual intercourse is prohibited, tests are conducted to examine the uterus and fallopian tubes. These may include hysterosalpingography, hysteroscopy, or laparoscopy to evaluate the condition of the fallopian tubes. Third, monitoring ovulation with ultrasound begins from the 8th to 10th day of the menstrual cycle, tracking the development of follicles and the uterine lining until the follicle matures and ovulation occurs.