Emerging biochemistry tests 2: fertility investigations

Question 1

Define infertility

Answer 1

Failure to conceive after regular unprotected sexual intercourse for 2 years in absence of known reproductive pathology

Question 2

When is a referral to a specialist given?

Answer 2

After 1 year of regular bareback and no bun in the oven

Question 3

What 7 tests/questions does the specialise do/ask?

Answer 3

1)is the woman ovulating 2)is the store of eggs appropriate for her age 3)does the dude have plenty of strong swimmers 4)are the fallopian tubes patent 5)age of woman 6)duration of subfertility 7)stable relationship

Question 4

What is the one test for a dude?

Answer 4

semen analysis

Question 5

What are the 6 tests for a woman

Answer 5

1)mid luteal progesterone 2)day 3 FSH/LH/Estradiol 3)chlamydia screen 4)pelvic ultrasound screen 5)rubella antibody titre 6) cervical smear

Question 6

What are 2 new tests for egg #?

Answer 6

1)serum anti mullerian hormone AMH 2)antral follicle count by USScan

Question 7

Where does maximal expression occur?

Answer 7

preantral and small antral follicles

Question 8

where does expression disappear?

Answer 8

in maturing peovulatory follicles

Question 9

WHAT is AMH?

Answer 9

Anti mullerian hormone, produced by antral follicles. measurement independent of cycle. measures antral follicle pool and used as a measurement of ovarian reserve.

Question 10

AMH assays?

Answer 10

can be analysed on automated immunoassay platforms, but issues regarding variation particulary at lower levels