Your Ultimate Guide to Male and Female Fertility Testing

Initial (and Important!) Fertility Tests

Before starting fertility treatment, men and women must provide tests for sexually transmitted infections (such as HIV and syphilis) and, in the case of women, toxoplasma and cytomegalovirus antibodies.

After the absence of an STI has been confirmed – or a course of treatment is prescribed to clear up any infection – patients who come to Tambre then undergo a basic fertility test. 

This can be performed at the clinic itself or at Tambre’s partner centres in the UK.

It is quite common for both men and women to be asked to undergo a karyotype test before beginning fertility treatment. Results take around two to three weeks and can be normal or altered in one of three ways: there is an increase in the number of chromosomes, a loss of chromosome information or an exchange of information between chromosomes.

Fertility Tests for Women

For a female fertility test, the specialist will want to know the levels of anti-mullerian hormone (AMH) and will carry out an ultrasound scan of the antral follicles to understand a woman’s ovarian reserve. A result of < 0.93 ng/ml suggests an insufficient ovarian reserve, an AMH level > 1.77 ng/ml indicates hyperstimulation of the ovaries and a result of > 4.9 ng/ml alerts fertility specialists that the woman is at risk of ovarian hyperstimulation syndrome. 

In addition, a blood test will be ordered that includes a haemogram, biochemistry and basic coagulation and your results will be returned to you in about one week. Checks of your thyroid hormones (such as TSH) or vitamin D levels, may also be requested.

A gynaecological check-up is also performed and depending on a woman’s age, she may undergo more tests. For example, if a woman is over 40 years old, results from a recent mammogram are requested.

Fertility Tests for Men  

In the case of men, a seminogram is required. At Clinica Tambre, we test:

• membrane permeability
• morphoanomaly index 
• seminal biochemistry

The results of the seminiogram can be interpreted differently, depending on your fertility specialist.

Additional Male Fertility Tests

If a male fertility test shows an altered semen analysis or if there has been a history of previous failures or miscarriages, one or more of these tests may be performed:

Chip FERTILE®

Also known as zyMot, Chip FERTILE® is the new CIMAB device that we use at Tambre to select spermatozoa prior to ICSI. This device is really useful and advantageous in cases where the ejaculate contains a high percentage of spermatozoa with double-stranded DNA fragmentation.

 Comet Fertility™ is a test that analyses the fragmentation of the semen sample. Fragmentation can be single or double and refers to the presence of “breaks” in the DNA (the molecule that contains all the genetic information in the sperm and in all our cells). Within 3 weeks, you’ll receive your results.

 Chromosperm and FISH: These studies are used to determine whether spermatozoa have the correct chromosomal content. Chromosperm evaluates a general chromosomal profile and FISH evaluates five pairs of chromosomes – your fertility specialist will have your results within three weeks. Ejaculate with a high percentage of sperm with altered chromosomes could lead to a higher number of aneuploid embryos.

Additional Female Fertility Tests 

If you’ve experienced implantation failure or repeated miscarriages, an endometrial receptivity study may be requested. At Tambre we have the most extensive endometrial analysis available, thanks to Igenomix: endomeTRIO. For this test, an endometrial biopsy is performed at the clinic and includes three important tests named ERA, EMMA and ALICE. You will likely receive your results within one week.

The ERA test gives your fertility specialist an indication of your implantation window; whether implantation occurs on the days we consider typical, or a few days before or after. If your implantation window is a few days early or late, there is nothing to worry about; the ERA test results simply allow your fertility clinic to personalise the embryo transfer to match your uterine environment.

The EMMA test analyses whether the microorganisms in the endometrium are normal and whether the proportion of these is adequate. Sometimes it is necessary to prescribe treatment to improve the endometrial flora.

The ALICE test diagnoses chronic endometrial infection. It identifies whether there are any abnormal microorganisms in the endometrium and helps your fertility specialist to prescribe the ideal antibiotic to treat it.

There are other tests Tambre’s immunologists can order in the case of previous failed cycles, such as KIR/HLA.

KIR and HLA-C Genotyping: This is an immunological compatibility study between the two people who provide gametes for assisted reproduction treatment, or between the recipient and the donor. Your results will be ready in one week.

Another fertility test that may be recommended is the Genetic Compatibility Test, also known as Genetic Matching. Every one of us has some form of genetic mutation but the Genetic Compatibility Test allows fertility specialists to detect whether a parent carries a particular type of mutation (abnormalities in a particular gene), with the aim to limit the transmission of genetic disorders to offspring. 

This test can be carried out if both parents provide their gametes and results are available after four weeks. If both partners provide gametes and some sort of incompatibility is found, we recommend that Preimplantation Genetic Screening (PGS) is carried out to select the healthiest embryos.

In the case of using donor eggs or donor sperm: the intended parent provides their gametes and one of the donor’s eggs (or donor sperm, where applicable) is tested for matching genetic mutations. If a donor is found to have the same genetic mutation, Tambre matches the intended parent with a different donor who is genetically compatible.

Following successful fertilisation, embryos can be tested to check for abnormalities so that only the healthiest embryos are implanted.

PGD (Preimplantation Genetic Diagnosis) is an assisted reproduction technique which allows embryologists to study the genetic material of embryos before implantation and select the healthiest embryos. This ensures there are no chromosome and/or genetic abnormalities transferred to the uterus. Within 12 to 14 working days, your embryologist will discover if your embryos are: euploid embryos, aneuploid embryos or mosaic embryos. 

myPrenatal

This Veritas test is capable of detecting the most common chromosomal abnormalities in the foetus, such as Down’s syndrome, Edwards’ syndrome and Patau’s syndrome. myPrenatal also reveals the sex of the foetus and alterations in the X and Y sex chromosomes (such as in the case of Turner’s syndrome and Klinefelter’s syndrome). 

It is considered a non-invasive test and is carried out via a blood test, which should be performed from the 10th week of gestation (in both single and twin pregnancies) at your clinic. At Tambre, we provide myPrenatal tests on-site so that our patients do not have to travel unnecessarily. Our nursing team then sends the sample to the laboratory and notify the patient when the result is ready – usually within five working days.