Have you ever sat in your car after a doctor's appointment and just stared out your windshield wondering what the heck they just said and what it all meant? At doctor's appointments they tend to jampack a plethora of information in the ten minutes they speak to you and much of the time you end up nodding while the medical jargon flies right over your head. This about sums up our first consultation with our fertility doctor. In our first meeting, our fertility specialist explained the number of prerequisite testing I, as the carrier, should undergo prior to delving into a treatment plan. Basically my doctor wanted to make sure all my parts worked before starting the process. I, of course, had nodded not understanding a word of what it all meant or why it was important.
In today's post I will explain the recommended testing needed prior to beginning your advanced reproductive treatments and why they are important for the process. Hopefully this will be a little easier to understand!
Test #1 - Complete Blood Work Up
The complete blood work up looks at your blood count and metabolic chemistry This can detect different health conditions that may impact pregnancy. This blood testing can detect conditions such as anemia, diabetes, kidney or liver disease etc. (Sutterhealth.org).
Test #2 - HIV and Other Infectious Diseases
This screening must be completed for patients who are going through the IUI or IVF process and tests for the following diseases in women:
Blood Type and Rh Factor*
HIV 1 and 2*
Hepatitis B Surface Antigen (HbSAg)
Hepatitis B Core Antibody (HepB CoreAb)*
Hepatitis C Antibody (HCV antibody)*
RPR (Syphilis)*
Rubella (German measles)
Varicella (Chicken pox)
Infections such as Hepatitis B, Hepatitis C, and HIV can be passed by sperm during the IUI or IVF process. Women, donors, and/or male partners are tested for these diseases. Women must be tested for these diseases as they can cause serious complications during pregnancy and birth. Chicken pox can actually cause birth defects if a pregnant mother gets exposed in the first 20 weeks and it can also cause complications in newborns (Sutterhealth.org) From personal experience I learned that your chicken pox vaccine can wear off after so many years so make sure you get this checked.
*These tests are also required for male partners if they are providing their sperm for IUI or IVF.
Test #3 - Hysterasalpingogram (HSG)
The HSG test is an x-ray procedure to assess the fallopian tubes. This test allows a specialist to see if the fallopian tubes are open or blocked and based on this information decide which treatment is best for you. If your doctor finds your tubes are blocked then they may recommend performing a surgical procedure to unblock them or trying IVF. This procedure is done in the office and usually takes about 10 minutes. To learn more about this procedure check out this Hysterasalpingogram (HSG) Fact Sheet.
Test #4 - Ovarian Reserve Testing
Ovarian reserve testing is also known as Day 3 blood work because it must be completed on the third day of a woman's menstrual cycle. Day 3 blood work tests the levels of different hormones such as estrogen, FSH which is a follicle-stimulating hormone that allows the body to tell the ovary to mature an egg for fertilization, AMH (anti-Mullerian hormone) which is a predictor of a woman's egg supply, and LH (luteinizing hormone) which shows the maturity and release of a follicle. This test allows your fertility specialist to understand the number of and quality of your eggs in your ovaries (Khan, 2015). This testing can also determine how your body will respond to treatment and medications.
Test #5 - Sonohysterography (SHG)
The SHG test is essentially an internal ultrasound of the uterus. The x-ray is used to assess the uterus and the ovaries. This allows the doctor to see if there are any abnormalities in the uterus. This test also takes approximately 5-10 minutes and is done in the office. If you want to learn more about the SHG test check out this SHG fact sheet.
Test #6 - Thyroid Function
The doctor will also conduct a blood test to assess your thyroid function. An issue with your thyroid function can affect a woman's period, ovulation, and pregnancy. To learn more about how thyroid function affects fertility visit "Hypothyroidism and Fertility."
Test #7 Ovulation Tests: Urine Luteinizing Hormone Test
Prior to discussing a treatment plan, your doctor will want you to complete ovulation tests to find out when you are ovulating. The luteinizing hormone is released 24 to 36 hours prior to ovulation this is also known as your "peak". Knowing when your peak is allows you and the doctor to know when is the best time to have intercourse or complete the IUI process for the best results.
Closing Statement
These are 7 tests that are recommended prior to beginning the treatment process. Remember your doctor may recommend more or less testing, but make sure you have the research and knowledge to know what you should be tested for. Don't be afraid to ask questions and have your specialist clarify any information you may not understand. You have a right to know what is being done and why.
References
Hyperthyroidism and fertility. CREATE Fertility Natural IVF. (2015, May 21). Retrieved April 30, 2023, from https://www.createfertility.co.uk/fertility-guide/conditions/hyperthyroidism-and-fertility#:~:text=Thyroid%20hormone%20levels%20can%20be,have%20abnormal%20thyroid%20hormone%20levels.
Hysterosalpingogram (HSG). Reproductive Facts. (n.d.). Retrieved April 30, 2023, from https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/hysterosalpingogram-hsg/
Preconception Testing. Sutter Health. (n.d.). Retrieved April 30, 2023, from https://www.sutterhealth.org/services/fertility/preconception-testing
Prerequisite testing. SART. (n.d.). Retrieved April 30, 2023, from https://www.sart.org/patients/a-patients-guide-to-assisted-reproductive-technology/general-information/prerequisite-testing/
Shady Grove Fertility. (2021, September 30). The infertility work-up: What's routine and what's not? Shady Grove Fertility. Retrieved April 30, 2023, from https://www.shadygrovefertility.com/article/the-infertility-work-up-whats-routine-and-whats-not/
UCSF Health. (2022, December 19). Intrauterine insemination (IUI). ucsfhealth.org. Retrieved April 30, 2023, from https://www.ucsfhealth.org/treatments/intrauterine-insemination
Comentarios