Fertility Evaluation
Discover your path to parenthood. Accurate diagnosis leads to faster success. Improve Your Chances of Getting Pregnant with Comprehensive Fertility Assessment Services.
Basic assessment
We at Bavishi fertility institute follow a one visit/ one cycle approach for diagnosis. In the first visit only or in one menstrual cycle, necessary tests are done to arrive at a primary diagnosis. This test includes male partner semen examination, ovarian reserve evaluation, ultrasound & ovulation tracking, basic hormone and other blood tests.
Semen Analysis
Contrary to historical knowledge, infertility is not strictly a female problem and involves men in almost half of the cases. Semen is checked for adequacy of sperm numbers(count), movement (motility) and structure (shape). Other parameters like semen volume, sperm viability and biochemical test are also done. Sperm morphology is often neglected. It is recommended to use strict criteria to define normal sperm. Experts of our embryology team meticulously examine the sample for any abnormality. Semen analysis is necessary even if there is no problem with sexual function or the male partner has fathered a child before
Hormonal tests
Regardless of your gender, hormones play a significant role in your ability, or inability, to procreate. Certain hormonal imbalances can contribute to infertility, and hormonal tests allow us to detect and treat these problems with a personalised hormonal treatment plan. Hormone evaluation includes measuring hormones secreted by the ovary, pituitary, thyroid, adrenals, testes and others. We customise your hormone evaluation per your medical conditions.
Evaluation of the Ovarian Reserve
It requires experience and attitude to judge ovarian reserve at the very first evaluation. Your egg supply, or ovarian reserve, declines consistently throughout your life, starting before birth. As a woman ages, the number of eggs decreases until most of her eggs runs out, and menopause begins.
An evaluation of the ovarian reserve is vital for effective fertility treatment planning. It measures the number of eggs a woman currently has. While evaluating ovarian reserve Age, Anti Müllerian Hormone (AMH), a blood test and Antral Follicle Count (AFC) are the most important markers. AFC is the number of follicles or egg sacs seen by transvaginal ultrasound.
If your ovarian reserve is low, you should consider faster treatment options like IVF. If your ovarian reserve is very low, advanced treatments like our signature ovarian rejuvenationcan help you have a reasonable chance of conceiving with your own eggs
3D ultrasound
Ultrasound can identify any structural problems in the uterus like fibroids, polyp and ovaries like various types of ovarian cyst and endometrium like its thickness, quality and correlation with the phase of ovulation. It can also give us an idea about endometriosis, tubal disease etc. It is one simple, non-invasive, in-house tool that tells us accurately about the diagnosis of pathology and sono endocrinology.
Tubal Testing
Various tests can be done to check if tubes are open. It can be checked with the help of ultrasonography by a procedure called SSG or with the X-ray by a procedure called HSG. Different media are inserted in the uterus in both procedures, and whether they pass through the tube and reach the abdominal cavity is checked. If any abnormality is found or ultrasound suggests a possible abnormality, further evaluation by laparoscopy is suggested.
Open tubes do not mean normal tubes as these tests are relatively a crude estimate of tubal patency but not tubal potency–function.
Ovulation Tracking
How the follicle develops, matures and ovulates in the ovaries is monitored by serial TVS (transvaginal sonography) every 2-4 days. Along with the follicle, the uterine lining (endometrium) is also monitored. It is commonly combined with treatment where medications are given to produce more and better quality eggs, around the time ovulation daily, or alternate day sexual intercourse is recommended. This form of treatment is called Ovulation Induction and Planned Relations (OI+PR).
Advanced Assessment
Advanced assessment may be required in patients who fail to conceive with simple or advanced treatment. When baseline tests show abnormality, advance evaluation is warranted.
Sperm DNA Fragmentation
The integrity of DNA in the sperm is crucial for successful fertilisation and normal embryo development. High sperm DNA fragmentation may lead to male subfertility, IVF failure and miscarriage. The findings of this test are independent of routine semen analysis. High DNA fragmentation means poor sperm DNA integrity. Unlike other genetic tests, Sperm DNA fragmentation can vary over time; in some conditions, it is possible to reduce DNA fragmentation.
The test indicates long unexplained infertility, IUI failure, IVF failure, or poor fertilisation in the IVF cycle.
High DNA fragmentation can be caused by Infection, Elevated testicular temperature, Smoking, alcohol, environmental and occupational pollutants, Advanced chronological age, Varicocele etc.
Treatment includes correction of underlying problems, antioxidant supplements. More often than not, the treatments are ineffective, and IVF – ICSI rather than conventional IVF is the treatment of choice. Advanced sperm selection techniques during IVF- ICSI can be very useful in this condition.
Hysteroscopy
Hysteroscopy allows us to view the inside of your uterus to inspect it for signs of abnormality. A hysteroscope is a thin tube with a light and a camera to provide clear, concise images of the uterus from inside. Hysteroscopy also allows your doctor to operate on you immediately, if necessary, by inserting small surgical instruments through the hysteroscope. Read More
Genetic Tests
Genetics play an important role in infertility, miscarriages and IVF failure. Various chromosomal rearrangements in male and or female partners can cause difficulties. The common test is a karyotype to study the overall genetic structure of the couple. Advanced tests can be performed by an aCGH or NGS platform on the embryo or miscarried foetus for a detailed evaluation.
Specialised genetic tests can evaluate reasons for poor ovulation, poor ovarian response in IVF, poor fertilisation with IVF and male subfertility.
ERA Test
This is a test for the evaluation of IVF failure. It studies the gene expression profile of the endometrium at the time of embryo transfer. It determines the best time for embryo transfer. Read More
Preimplantation Genetic Testing (PGT) and Embryo Biopsy
Your embryos, produced by In Vitro Fertilization – IVF, can be tested to ensure they have the correct number of chromosomes (PGT-A / PGS) or to check for the presence of specific unique genes that can cause disease (PGT-M / PGD). To do this, the embryos are allowed to grow to a stage called a blastocyst, which takes five to six days. A few of the cells from the embryos are removed on day 3/4/5 of embryo development during a microscopic procedure known as an embryo biopsy. They are then analysed by a laboratory specialised in genetics. Your doctor can then transfer the embryos which contain the normal number of chromosomes/ are disease free, increasing the chance of getting pregnant with reduced miscarriage risk.
Other tests for a male partner
- Scrotal ultrasound to look for any local abnormality
- Y chromosome microdeletion genetic test for patients of very low sperm count or zero count – Azoospermia
- MRI of the brain in selected cases of hormone dysfunction and azoospermia-zero count
- Testicular biopsy in azoospermia-zero count
Other tests for female partner
- Laparoscopy for a detailed evaluation of pelvic area and uterus
- MRI of the brain in selected cases of hormone dysfunction
- Infection testing
- Vitamin levels
- Physical fitness for carrying pregnancy and childbirth.
Advantage Bavishi
We are fully geared to pay attention to every minute details for accurate diagnosis that charts the highly customised path to success. Our individualised and personalised assessment policy fully respects your privacy, dignity, comfort, likes and dislikes and personal preferences.
Judicious use of investigations, minimum required tests, maximum evaluation at a single visit, emphasis on non-invasive techniques helps us achieve perfection with minimum discomfort and offer the best value for money.
Ahmedabad