Before a couple under go IVF treatment, there are a number of tests and initial investigations they undergo under the guidance of their treating fertility specialist.
Firstly, three essential questions are asked before IVF fertility treatment is even considered.
In Australia, most IVF clinics offer IVF treatment up to the age of natural menopause. However, patients are counselled that after the age of 45, the success rate of IVF treatment has only been achieved in a very small number of cases. Women under the age of 35 have a good overall outlook with IVF treatment with a very high likelihood of eventual conception, provided there is no cause for sterility present. Women in the 35-40 age-group still have a reasonable chance of a pregnancy, though they should be counselled to start sooner rather than later.
With regard to women who have had a previous pregnancy, there have been a number of studies, which indicate a better outcome from IVF fertility treatment for these women. This is particularly so when the pregnancy has been within five years.
The duration of trying is the third important feature in assessing the prognosis of a couple before IVF treatment is considered. Within the first three years of trying, there is generally a reasonable prospect of spontaneous conception (although most couples will be seeking active intervention long before this), while from three to seven years of trying is the time when IVF is a particularly effective intervention. Beyond seven years of attempted conception, even the success rate of IVF treatment is limited.
The answers to these three questions provide a very useful basis for planning any IVF treatment.
Standard investigations prior to IVF treatment will include looking at a woman?s menstrual history, investigating any pain, considering medications she may be taking which could be hindering conception and taking into account any past surgeries. All of these elements could impact on the timing and type of IVF treatment offered.
For males, typical factors to be considered before IVF treatment include any past surgeries, any androgen abuse and any illnesses and infections, such as mumps, or STIs.
What are some of the routine examinations a couple may have to undergo prior to the process of IVF treatment? Ultrasounds may be used to diagnose conditions such as PCOS and endometriosis in the female, both of which can impact on the success of IVF treatment. The ovarian reserve may also be measured using an AMH (Anti Mullerian Hormone) test. In some clinics, an AMH level is now a routine part of the assessment of even young women in order to identify the small proportion of women with a reduced ovarian reserve of oocytes where accelerated referral and IVF treatment is indicated.
For males, a semen analysis is mandatory. Sperm DNA fragmentation and sperm antibodies may also be examined. This is because in recent years, there has been a growing awareness of the potential for genetic damage in the human spermatozoa. This appears to be more prevalent in older men, in men with medical conditions such as diabetes and in men whose wives are experiencing difficulties in reproduction.