Fertility Assessment | Fertility Tests London | Aria Fertility (2024)

What is a fertility test?

A fertility test at Aria Fertility allows couples, as well as single men or women, to visit the clinic for one appointment where specific tests, will allow us to provide an assessment of your fertility. The assessment will identify any potential problems and help you to decide whether to try for a baby straight away, or potentially leave it till later.

The fertility assessment will provide an insight into your fertility health from a range of tests which evaluate your lifestyle and other health issues. A full explanation of these results will be given and their bearing on your fertility health discussed. These tests are not intended as a replacement for the more thorough medical diagnostic tests which may be recommended once the findings of the fertility assessment are known.

Female fertility assessment.

Once you have met the consultant for a discussion to review your medical history and lifestyle there are some further tests which will be performed to assess your fertility.

Body Mass Index (BMI).

The body mass index is evaluated by taking measurement of your height and weight. By doing this we will establish if you are a healthy weight or possibly underweight or overweight. Certain studies have shown that if you are not of a healthy weight your fertility could be reduced. We will be able to provide suggestions about changes to your lifestyle to help achieve a healthy weight and maximise your fertility potential.

Ovarian Reserve.

Your ovarian reserve refers to the number of eggs which remain within the ovaries that can ovulate and form a pregnancy. This is most commonly assessed through an ultrasound scan of the ovaries together with a blood test.

Ultrasound.

A simple ultrasound scan of the ovaries in the early stages of your cycle can be used to measure small fluid filled sacs, this is called an antral follicle count (AFC). When both ovaries are combined, we would expect 8-10 antral follicles – this would be an indicator of someone with a healthy fertility potential. However, with increasing age we would expect to see this number decrease and subsequently fertility decrease with it.

Blood Test.

A blood test is required to measure a natural hormone known as Anti-Müllerian hormone (AMH). This hormone is secreted from the small follicles within the ovaries, the level of which provides an estimate of the number of eggs which still remain within the ovaries. AMH production does diminish with age as the number of follicles slowly reduce and becomes undetectable at the point of menopause.

AMH levels strongly correlate with the antral follicle count (AFC). With this information we can establish whether you could defer trying for a baby for a few years or whether the reproductive health is reduced to the extent that you should not delay starting a family if your circumstances permit it.

Detailed Ultrasound Scan.

A three-dimensional ultrasound scan to check the ovaries and womb (uterus). If the ultrasound scan does highlight any problems or abnormalities further diagnostic tests may be required to identify the cause and extent of any potential problems.

Infection Screening.

Chlamydia is the most common sexually transmitted infection in the UK and affects both males and females. Chlamydia can cause significant damage to the Fallopian tubes in females if left untreated. We will recommend testing for Chlamydia through a simple urine test.

Rubella.

Rubella is an infectious disease that in most cases presents as a mild condition and an infection often passes unnoticed. The disease does not affect your ability to conceive but it can be serious in pregnant women as it can harm the unborn baby. A blood test can be performed to identify if you are immune to Rubella or not. If you are not immune, then it would be a strongly recommend stopping trying to conceive until you have been vaccinated against Rubella.

Sonohysterogram.

This test will check that the cavity of the uterus is normal, it reveals if there are any lesions on the lining of the womb or polyps, fibroids in the cavity; it requires an injection of sterile saline into the cavity of the uterus.

HyCoSy (Ultrasound).

This test will check whether your fallopian tubes are open and working properly. This test requires that a special dye is injected through the cervix in the womb and subsequently through the fallopian tubes. It is a minimally invasive procedure and provides valuable information about the fallopian tubes and your uterine cavity.

MALE FERTILITY ASSESSMENT.

Once you have met the consultant for a discussion to review your medical history and lifestyle there are some further tests which can be performed to assess your fertility.

Body Mass Index (BMI).

The body mass index is evaluated by taking measurement of your height and weight. By doing this we will establish if you are a healthy weight or possibly underweight or overweight. Certain studies have shown that if you are not of a healthy weight your fertility could be reduced. We will be able to provide suggestions about changes to your lifestyle to help achieve a healthy weight and maximise your fertility potential.

Semen Analysis (Sperm Test).

It is estimated that between 20-30% of males are affected with infertility. It is essential therefore that we perform a semen assessment to understand if the quality of your sperm is negatively affecting your fertility.

For an accurate assessment of your semen sample, we require you to abstain from sexual intercourse or ejaculation for 2-5 days prior to the test. A semen analysis test measures multiple different parameters within a semen sample:

Volume
The volume of semen should be 1.5 ml or more. If the volume of semen is low this could potentially indicate that amount of sperm required to fertilise an egg is also low.

Sperm concentration (number of sperm)
The number of sperms we would expect to see for a normal sample would be 15 million spermatozoa per ml or more. Any less than this could indicate an issue with your fertility. Fertility treatments are very effective in treating of infertility due to low sperm count.

Sperm motility
This is the assessment of the percentage of sperm with progressive motility (i.e., mobile and moving) and those which display non-progressive motility (i.e., immobile or dead). In a normal sample we would expect 40% or more sperm to be motile, with a minimum of 32% showing good forward movement. Any less than this may highlight an issue or mean there are too few motile sperm to reach the egg and fertilise it.

Morphology (shape & appearance of the sperm)
Normally, sperm are mass produced by the millions and for this reason many of the sperm which are produced within the body are formed incorrectly and carry abnormalities. We expect to see in a normal sample only 4% or more of sperm being of a normal shape and appearance, which we report as those having a normal morphology.

If the semen analysis result is poor some further tests could be recommended:

Sperm DNA fragmentation testing
High levels of sperm DNA fragmentation are associated with reduced natural pregnancy rates and affect 20-30% of men seeking fertility treatment. Sperm DNA fragmentation is also correlated with poor embryo development and a reduction in pregnancy rates following assisted conception (IVF) treatments. The reason for this is because high levels of DNA damage in the sperm can promote the embryo to stop developing, arrest and enter into a pathway of degeneration.

A normal semen analysis does not necessarily mean that the sperm are free from DNA damage. This is because a routine analysis of the sperm cannot evaluate the DNA fragmentation. High levels of DNA fragmentation can be reduced through nutritional (antioxidants) and lifestyle changes and treatments of any underlying infections.

Infection Screening.

Chlamydia affects 1 in 10 young males in the UK and infection can affect sperm function and male fertility. It is the most common cause of inflammation in the reproductive organs of men under the age of 35. If left untreated it can cause infertility. We will recommend testing for Chlamydia through a simple urine test.

Fertility Assessment | Fertility Tests London | Aria Fertility (2024)

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