Basic Examination

To realize the cause of infertility, we suggest both of the spouses undergoing the following basic examinations:

Semen Analysis
精液分析

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.

When could I have the sample collected?
Make an appointment with the fertility center after consultation with the doctor. Please avoid sexual intercourse for 2-7 days prior to the intended day for sample collection.
Where to do the examination?
At Stork Fertility Center - We will arrange a private and cozy room for you. Please collect the sample into a sterilized cup we provided by masturbating.
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℃.
Preparation for a newborn

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.

子宮基本構造

月經周期圖

月經周期圖

Hormone Study
To estimate the rate of potentially successful pregnancy and if there are any hormonal imbalanaces that causes infertility.
3 indexs of ovarian function:
  1. Prolactin (PRL)

    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.

  2. 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.

  3. Testosterone

    Excessive androgenic hormone due to PCOS or congenital adrenal hyperplasia would lead to female infertility.

Ovarian Reserve Examination
The number of oocytes of a female is fixed after birth. There are about a million of primary oocytes on both sides of the ovaries. As getting older, the number of oocytes would decrease gradually. By taking a blood draw, ovarian reserve examination allows us to realize the ovarian function, which also can be interpreted as a reference for the following treatment.

2 Major Index of Ovarian Reserve:

  1. Anti-Mullerian hormone (AMH)

    AMH, secreted by follicles, is the most important index of the ovarian function. AMH由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
     
  2. 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
Antral follicle counts (AFC)
AFC is examined on day 1-3 of the period by ultrasound.
Number of follicles ≦5 >5
Response after stimulation Bad Good
Hysterosalpingography (HSG)
Fallopian tube is the spot where the sperm meet the oocyte. Therefore, the patency of the fallopian tubes is important for the following treatment. Intrauterine Insemination(IUI) and Timed Sexual Intercourse(TSI) are both applicable if the fallopian tubes are patent. However, if there are obstruction or hydrosalpinx in the fallopian tubes, the chances of ectopic pregnancy would increase. Also, the embedding of the embryo would be affected because the inflammatory fluid may flow into the uterus. The best solution of patients with blocked fallopian tubes is to undergo a Salpingectomy and IVF.
子宮輸卵管攝影

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.

Transvaginal Sonography (TVS)
Sonography (sona) is used to check the interval reproductive organs for any abnormalities, including the cervix, uterus, ovary and endometrium lining. It is also used to estimate ovulation period and measure uterine wall thickness.
Period Examination Purpose
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