Before starting an in vitro procedure, both partners undergo a series of fertility and general health tests. These tests not only ensure the safety and effectiveness of the treatment, but also provide valuable insight into potential challenges and strategies to optimize success.
SEROLOGICAL TESTS
The first type of tests that are done are the blood ones for HIV, Hepatitis B, Hepatitis C and Syphilis. These are the most common serious transmissible diseases (transmitted from person to person), which is why the directives on cells and tissues of the European Union, as well as the Bulgarian legislation, require that all in vitro patients be tested for them. A positive result does not always require termination of the procedure. According to the Bulgarian law, the procedure can continue if «the treatment facility has equipment and a validated procedure for processing and separate storage» of the infected biological material.
Blood tests for HIV, Hepatitis B, Hepatitis C and Syphilis should be done NO sooner than 3 months before the day of the procedure (ovarian follicle puncture). If they are older than three months, they are no longer valid.
In the presence of risk factors (e.g. travel to countries with an increased incidence of malaria, cytomegalovirus, etc.), additional blood tests are required.
MICROBIOLOGICAL TESTS
Both the woman and the man undergo a microbiological examination — of vaginal discharge and, respectively, of semen. The test shows whether these secretions contain microorganisms (e.g. bacteria, fungi) and what types. In men, it is mandatory to do urine test for chlamydia. The presence of certain species requires antibiotic/antimycotic treatment before the procedure. Microbiological tests of both partners should be done NO EARLIER than 30 days before the puncture.
HORMONES
Hormonal testing is absolutely essential in evaluating your fertility and determining the next steps in your treatment. They include:
- Follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) — are tested on day 3-5 of the menstrual cycle.
- Anti-Müllerian hormone — gives important information about the ovarian reserve.
- Prolactin (PRL). It is examined 4 hours after waking up. 2-3 days before the test, there should be no sexual contact and breast stimulation, because this can lead to false positive results. Stress and certain medications also affect the results.
ADDITIONAL TESTS
Depending on your medical history, you will be recommended additional tests, including:
- Thyroid function test (TSH, fT3, fT4, TAT, MAT);
- Oral glucose tolerance test. Its goal is the early detection of insulin resistance and diabetes. If you are already diagnosed with any of these diseases it is necessary that they are well controlled before starting IVF.
- Screening for antiphospholipid syndrome;
- Genetic testing
- Vitamin B12.
WHICH TESTS ARE REQUIRED FOR MEN?
As a first step, you will be required to do is a semen analysis. It is absolutely mandatory because it can diagnose or rule out male factor for infertility. The reproductive medicine specialist can also order additional tests — for example, testosterone.
To obtain the most accurate results, always adhere to the necessary preparation for a certain test. If you have questions or uncertainties, do not hesitate to contact your medical provider.