Fertility Investigations Flashcards
Ultrasound scans
To rule out any structural abnormalities.
Serum FSH,
oestrogen and
progesterone
- Day 1–5 oestrogen test.
- Day 21 progesterone test (to
evaluate progesterone adequacy)
Thyroid function
To check thyroid function. Usually
check for TSH only. Best to have
a full thyroid panel (TSH, T3,T4,
thyroid antibodies, possibly rT3)
Glucose levels and
insulin resistance
Elevated blood sugar levels and insulin resistance can affect ovulation / cycle length
AMH (anti- Mullerian hormone)
combined with AFC (antral
follicle count)
AMH is a protein that is used as a marker of ovarian
reserve. It is tested using blood and is produced by
granulosa cells of immature ovarian follicles.
* ↑ AMH could be PCO. ↓ AMH / reserve
is likely to respond poorly to IVF drugs.
* AFC is done via ultrasound scan to
check numbers of follicles in both ovaries
Sperm sample
To check for sperm motility and morphology, as well as semen volume
Other
Testing for infections such as STIs, UTIs etc.
Toxic metals
profile
Hair / urine mineral analysis to identify
levels of toxic metals in body.
MTHFR and
COMT genetic
variations
DNA testing; MTHFR (as discussed). COMT
polymorphisms can disturb oestrogen balance,
e.g., COMT Val / Met polymorphism increases
the risk of premature ovarian insufficiency
Homocysteine
↑ homocysteine levels can indicate methylation issues.
Adrenal stress
profile
Can highlight a need for support due to the suppressive effects of cortisol on fertility
RBC minerals
Tests intracellular levels of minerals
(zinc, magnesium) instead of blood levels.
Oxidative markers (e.g.
Genova Oxidative Stress
test or DUTCH)
Blood sample (e.g., Genova) ―
evaluates the oxidative stress
status and antioxidant reserve.
* The oxidative stress marker
‘8-OHdG’ is measured via
panels such as DUTCH (urine)
Immune investigations
NK cells, HLA, antiphospholipid antibodies
Serum or urine analysis
of amino acids (male)
Amino acids can affect sperm count (carnitine /
arginine). E.g., Genova amino acid panels.
