Answer from: Raúl Olivares, MD
The basic diagnosis tests before considering IVF are, in our opinion, general blood tests to confirm that you are healthy, including a mammogram, coagulation test, and all the biochemical studies that are usually requested.
The Complete hormonal profile, specifically, should include Anti-Müllerian hormone (AMH), which will help us first confirm that it is worth trying an IVF with your own eggs. Second, it is going to help us decide which is a protocol that we are going to use. The lower the AMH, the stronger the protocol should be. We know that these ovaries are not going to many eggs. It is also important to have a scan just to confirm that there is nothing wrong with the uterus because if there is anything wrong with it, it should be fixed before we start the stimulation. Those could be polyps, fibroids, cysts. We also need to do a spermogram sometimes, more than one. If the first one is normal and there are no other risk factors on the male side, we don’t need to repeat it. In cases where there is an abnormal spermogram, we usually recommend repeating it at least once just to confirm that it was not an exceptional circumstance. Sometimes there is huge variability in the quality of the spermogram, and then we proceed with a second one.
To sum up, you need to check your hormones, do general blood tests including AMH to decide the protocol, and confirm that it is worth starting the IVF, and then do a scan and spermogram, that’s the basic set-up.
In some other cases, if there is something in the medical history that could be a problem, like having sexually transmitted diseases, it would make sense to carry out other tests, just focus on these risk factors.
Answer from: Harry Karpouzis, MD, MRCOG, DIUE
The chances of success in IVF are getting higher if we work on a personalized basis. Each case is different, and when we treat each case as a unique one, we increased the chances of success. This is why every single couple going ahead with IVF needs to have some initial baseline test. Sometimes, other tests may be needed depending on the history and, of course, records of any previous attempts as well. The baseline blood test that the couple needs to have to create a protocol for them is an Anti-Müllerian hormone for the female partner that shows the number of eggs that she has in comparison to other women at her age. A hormonal check on day 2 to 4 of the cycle including thyroid hormones like prolactin.
Sometimes an HSG might be needed or previews laparoscopic with a dye test to see if there are any problems with the tubes. Patency of the tubes is not always needed in IVF cycles, but we need to see if there is a mild hydrosalpinx, for example, or if there is any suspicion from the ultrasound regarding that, then we need to clarify that before the IVF because hydrosalpinx needs to be operated before to increase the chances. On all the occasions, we need another follicular count and the baseline ultrasound in which we check the endometrium, if there are any cysts in the ovaries or if there is any evidence of endometriosis, and we need an antral follicle count as well because the combination of the antral follicle count is counted together with AMH, these are the basic things that help us adjust the dose of the medication in IVF.
Sperm analysis is very important as well. We definitely need to have infection tests for both of the partners HIV, Hepatitis B, C and syphilis test are needed, and they need to be recent tests as well. Now depending on the medical history, we may need the extra tests, for example, if there is suspicion of endometriosis, sometimes a laparoscopy may be advised. If there is suspicion of polyps, the endometrium is not getting thicker, or for example, there is a bicornuate uterus. Then we always suggest a hysteroscopy, which is always suggested after unexplained IVF failures, which means no implantation with a good quality embryo.
Sometimes we ask for more specific tests, for example, in couples that have a history of recurrent miscarriages or recurrent failures of implantation, we may ask for a thrombophilia check, we may ask about natural killer tests, immunological tests, karyotypes. There are a lot of tests that depending on the case, may be needed. Nowadays, we have some genetic tests as well as ERA, EMMA, ALICE, which actually can be suggested in cases of recurrent implantation failures or unexplained infertility.
What tests are important before an IVF including, blood tests, genetic tests, and ultrasound scans?
There are several tests for IVF treatment that will be necessary and will be a part of the IVF process, that way, the best treatment option will be chosen for your situation. It is always crucial to discuss what sort of tests you need with your doctor. IVF tests – what are the most important tests I should perform before undergoing IVF? What tests are done to check female fertility before starting an IVF cycle? What hormone tests should be performed for IVF, and when?