To realize the cause of infertility, we suggest both of the spouses undergoing the following basic examinations:
Semen Analysis is done according to 2010 WHO regulations in order to test the forward motility, quality and quantity of sperm collected.
- Total Sperm number: >39 millions/ ejaculate
- Total Motility: >40% motile
- Progressive Motility: >32% with forward motility
- Sperm Morphology: >4% normal forms
※ The formation of sperm cells requires 72-75 days. The quality of sperm is easily influenced by external factors, such as: change in seasons, temperature, body condition and living standards. Handling of semen sample is delicate. It is not suggested to rely on the results on the first testing due to above possible factors affecting the result. It is better to undergo at least 2-3 examinations.
At your own place - By masturbation, collect the ejaculated sperm in the sterilized cup. Within 60 minutes from time of ejaculation, retrieved sperm sample must be submitted to the clinic. Ideal temperature for transporting sample is around 25℃.
The process of pregnancy creates the strongest bonding of mother and baby. Women’s body is designed as a palace welcoming the new birth. The most important 3 factors of a pregnancy are: ovaries, fallopian tube and uterus.
3 indexs of ovarian function:
Secreted by pituitary gland, PRL is considering as antagonist of hormone regarding the growth of follicles. Therefore, higher PRL level would inhibit the ovulation, and leads to infertility.
Thyroid-stimulating hormone (TSH)
Secreted by anterior pituitary, higher TSH is usually associated with hypothyroidism. Since the structure of TSH is similar to ovulation related hormone such as LH and FSH, higher TSH would also affect the function of ovarian.
Excessive androgenic hormone due to PCOS or congenital adrenal hyperplasia would lead to female infertility.
2 Major Index of Ovarian Reserve：
Anti-Mullerian hormone (AMH)
AMH, secreted by follicles, is the most important index of the ovarian function. AMH level would be lower as the number of follicles decline.
AMH (ng/ml) <0.8 0.8-2 2-6 >6 Ovarian Reserve Hugely Declined Declined Adequate Abundant Number of Oocytes of each IVF cycle <2 <4 4-10 >10
The correlation between AMH and age：
Age 25↓ 35y 38y 40y 43↑ AMH International Facilities >6 4 3 2 1 Stork Fertility Center >6 2.2 1.3 0.9 0.7
Follicle Stimulating Hormone (FSH)
FSH is one of the hormone that stimulate the maturation of follicles. Secreted by pituitary gland, FSH is also an ovarian reserve index. To rule out the fluctuation, FSH is suggested to test on day 1-3 of the period and repeated for 2-3 times. When FSH>10 mIU/mL, the ovarian function is considered as hugely decline. (Note：For patients who have done the ovarian surgery or endometriosis, FSH would not be able to represent the ovarian function)/p>
FSH mIU/ml <8 8~10 10~12 12~25 >25 Ovarian Reserve Abundant Slightly Decline Hugely decline Nearly menopause Number of Oocytes of each IVF cycle >10 10±2 <8 <5 0~1
|Number of follicles||≦5||>5|
|Response after stimulation||Bad||Good|
HSG is an X-Ray test to examine the condition of the fallopian tubes and uterus to determine if there are any blocked tubes, abnormal uterine structures or growths. It’s recognized as a simple, convenient and with 80%-90% accuracy.
HSG must be conducted after menstrual period and before ovulation. If cycle is regular (28 days), it is best to conduct the HSG on the 7th -11th day of the cycle. If doing the HSG after day 11 is inevitable, contraception measures must be fulfilled throughout the cycle in case of pregnancy.
The test is usually done in 5-10 minutes, and the doctor will explain the result on the same day.
|Day 1~3||Size of follicles and ovaries||Ovarian function assessment|
|Day 12||Number and size of the follicles||Prediction of ovulation|
|Day 12||Endometrium thickness||Environment of embryo embedding|
|No discharge||Structure and size of uterus||Environment of embryo embedding|
The sona technician will cover the probe with a condom and gel, and then, insert it into the vagina slowly. The probe sends out sound waves, reflecting body structures to the computer, creating pictures. The procedure would take about 3 minutes