16e. Fertility - Fertility Investigations Flashcards
Examples of orthodox fertility investigations
Ultrasound
Serum FSH/oestrogen/progesterone
Thyroid function
Glucose/insulin resistance
Anti-Mullerian hormone
Antral follicle count
Sperm sample
Why is an ultrasound used to investigate fertility?
To rule out any structural abnormalities
When would oestrogen be checked?
Day 1-5 of cycle
Why would progesterone be checked?
Day 21 of cycle
Why are glucose levels checked in fertility?
Elevated blood glucose/IR can affect ovulation/cycle length
What is anti-Mullerian hormone?
Protein used as a marker for ovarian reserve
How is anti-Mullerian hormone tested?
Blood
What can increased anti-Mullerian hormone be a sign of?
PCOS
What does antral follicle count investigate?
Follicle numbers in both ovaries
How is antral follicle count investigated?
Ultrasound
What markers does a sperm sample test for?
Motility
Morphology
Volume
Examples of functional fertility investigations
Vaginal microbiome
Comprehensive hormone panels
Toxic metal profile
MTHFR/COMT genetic variations
Homocysteine
Adrenal stress profile
RBC minerals
Oxidative markers
Immune investigations
Serum/urine analysis of amino acids
Anti-Mullerian hormone
DNA fragmentation
How can toxic metals be tested?
Hair
Urine
Why would homocysteine levels be tested for fertility?
High homocysteine levels can indicate methylation issues
Why would an adrenal stress test be used for fertility?
To assess the suppressive effects of cortisol
Why would amino acids be tested for fertility?
Amino acids can affect sperm count
Examples of comprehensive hormone panel testing
Genova Rhythm Plus
DUTCH test
What does the Genova Rhythm Plus test for?
Salivary assessment of oestrogen, progesterone, testosterone
Spans 28 days
Also tests cortisol, DHEA, melatonin
What does the DUTCH test for?
Sex hormones
Adrenal hormones
Their metabolites
Examples of assisted reproductive technologies
IVF (In vitro fertilisation)
Intracytoplasmic sperm injection
Intrauterine insemination
What does IVF involve?
Stimulation of ovaries
Egg retrieval
Egg fertilised in vitro with sperm
Fertilised embryos transferred into uterus
What does intracytoplasmic sperm injection involve?
Sperm injected into egg in vitro
(used when sperm abnormalities)
What does intrauterine insemination involve?
Sperm placed inside uterus around ovulation to facilitate fertilisation
Risks of IVF
Multiple births
Premature delivery
Low birth weight
Ectopic pregnancy
Cancer
Ovarian hyperstimulation syndrome
Egg retrieval procedure complications
