Basic Examination
6/11/2020 02:31:00 AM
To realize the cause of
infertility, we suggest both of the spouses undergoing the following basic
examinations:
Preparation for a newborn
The process of pregnancy creates the
strongest bonding of mother and baby. Women’s body is designed as a palace
welcoming the new birth. The most important 3 factors of a pregnancy are:
ovaries, fallopian tube and uterus.
FEMALE
FEMALE
Hormone Study
To estimate the rate of potentially
successful pregnancy and if there are any hormonal imbalanaces that causes
infertility.
3 indexs of ovarian function:
3 indexs of ovarian function:
1.
Prolactin (PRL)
Secreted by pituitary gland, PRL is considering as antagonist of hormone
regarding the growth of follicles. Therefore, higher PRL level would inhibit
the ovulation, and leads to infertility.
2.
Thyroid-stimulating hormone (TSH)
Secreted by anterior pituitary, higher TSH is usually associated with
hypothyroidism. Since the structure of TSH is similar to ovulation related
hormone such as LH and FSH, higher TSH would also affect the function of
ovarian.
3.
Testosterone
Excessive androgenic hormone due to PCOS or congenital adrenal hyperplasia
would lead to female infertility.
Ovarian Reserve Examination
The number of oocytes of a female is
fixed after birth. There are about a million of primary oocytes on both sides
of the ovaries. As getting older, the number of oocytes would decrease
gradually. By taking a blood draw, ovarian reserve examination allows us to
realize the ovarian function, which also can be interpreted as a reference for
the following treatment.
2 Major Index of Ovarian
Reserve：
- Anti-Mullerian hormone
(AMH)
AMH, secreted by follicles, is the
most important index of the ovarian function. AMH由level would be lower as the number of follicles decline.
The correlation between AMH and age：
Age
|
25↓
|
35y
|
38y
|
40y
|
43↑
|
|
AMH
|
International
Facilities
|
above 6
|
4
|
3
|
2
|
1
|
Stork Fertility Center
|
above 6
|
2.2
|
1.3
|
0.9
|
0.7
|
|
2.
Follicle Stimulating Hormone (FSH)
FSH is one of the
hormone that stimulate the maturation of follicles. Secreted by pituitary gland,
FSH is also an ovarian reserve index. To rule out the fluctuation, FSH is
suggested to test on day 1-3 of the period and repeated for 2-3 times. When FSH>10
mIU/mL, the ovarian function is considered as hugely decline. (Note：For patients who
have done the ovarian surgery or endometriosis, FSH would not be able to
represent the ovarian function)
Antral follicle counts (AFC)
AFC is examined on day 1-3 of the
period by ultrasound.
Hysterosalpingography(HSG)
Fallopian tube is the spot where the sperm meet the oocyte. Therefore, the
patency of the fallopian tubes is important for the following treatment. Intrauterine
Insemination(IUI) and Timed Sexual Intercourse(TSI) are both applicable if the
fallopian tubes are patent. However, if
there are obstruction or hydrosalpinx in the fallopian tubes, the chances of
ectopic pregnancy would increase. Also, the embedding of the embryo would be
affected because the inflammatory fluid may flow into the uterus. The best
solution of patients with blocked fallopian tubes is to undergo a Salpingectomy
and IVF.
HSG is an X-Ray test to examine the condition
of the fallopian tubes and uterus to determine if there are any blocked tubes,
abnormal uterine structures or growths. It’s recognized as a simple, convenient
and with 80%-90% accuracy.
HSG
must be conducted after
menstrual period and before ovulation. If cycle is regular (28 days), it is
best to conduct the HSG on the 7th -11th day of the cycle. If doing the HSG
after day 11 is inevitable, contraception measures must be fulfilled throughout
the cycle in case of pregnancy.
The test is usually done in 5-10 minutes, and the doctor will explain the result on the same day.
The test is usually done in 5-10 minutes, and the doctor will explain the result on the same day.
Transvaginal Sonography(TVS)
Sonography (sona) is used to check the
interval reproductive organs for any abnormalities, including the cervix,
uterus, ovary and endometrium lining. It is also used to estimate ovulation
period and measure uterine wall thickness.
Period
|
Examination
|
Purpose
|
Day 1-3
|
Size of follicles and
ovaries
|
Ovarian function
assessment
|
Day 12
|
Number and size of the
follicles
|
Prediction of
ovulation
|
Day 12
|
Endometrium thickness
|
Environment of embryo
embedding
|
No discharge
|
Structure and size of
uterus
|
Environment of embryo
embedding
|
The
sona technician will cover the probe with a condom and gel, and then, insert it
into the vagina slowly. The probe sends out sound waves, reflecting body
structures to the computer, creating pictures. The procedure would take about 3
minutes.
MALE
Semen Analysis
Semen Analysis
Semen Analysis is done according to 2010 WHO regulations in order to test the forward motility, quality and quantity of sperm collected.
·
Total
Sperm number: >39 millions/ ejaculate
·
Total
Motility: >40% motile
·
Progressive
Motility: >32% with forward motility
·
Sperm
Morphology: >4% normal forms
※ The formation of sperm cells requires
72-75 days. The quality of sperm is easily
influenced by external factors, such as: change in seasons, temperature, body
condition and living standards. Handling of semen sample is delicate.
It is not suggested
to rely on the results on the first testing due to above possible factors
affecting the result. It is better to undergo at least 2-3 examinations.
When could I have the sample collected?
Make an appointment with the fertility center after consultation with the doctor. Please avoid sexual intercourse for 2-7 days prior to the intended day for sample collection.
Make an appointment with the fertility center after consultation with the doctor. Please avoid sexual intercourse for 2-7 days prior to the intended day for sample collection.
Where to do the
examination?
At Stork Fertility Center – We will arrange a private and cozy room for you.
Please collect the sample into a sterilized cup we provided by masturbating.
At your own place - By masturbation, collect the ejaculated sperm in the sterilized cup. Within 60 minutes from time of ejaculation, retrieved sperm sample must be submitted to the clinic. Ideal temperature for transporting sample is around 25℃.
At your own place - By masturbation, collect the ejaculated sperm in the sterilized cup. Within 60 minutes from time of ejaculation, retrieved sperm sample must be submitted to the clinic. Ideal temperature for transporting sample is around 25℃.