Ovarian reserve is a measure of the quantity of eggs contained within a woman’s ovary at any given point in time. The common tests for ovarian reserve include an ultrasound scan to measure the antral follicle count (AFC) and a blood test called Anti-Mullerian Hormone (AMH). None of these tests are absolutely accurate on their own and information from a combination of them is often used to assess ovarian reserve.
Female hormone profile
Female hormones, such as oestrogen, progesterone, luteinizing (LH) and follicle stimulating hormone (FSH) naturally fluctuate throughout the menstrual – and the fertility treatment – cycle. By performing blood tests on specific days, we can better understand your individual hormone levels at critical points – and with that, better plan your treatment. Other hormones, such as thyroid function and prolactin, can be done at any time.
Thrombophilia (clotting) screen
Thrombophilia describes any inherited or acquired disorders with an increased chance of abnormal blood clotting, something that shows itself in pregnancy when microscopic clots form in the placenta and deprive the fetus of adequate blood flow. This thrombophilia screening will search for any of those disorders and is generally recommended for women who have been suffering recurrent pregnancy loss, infertility, implantation failures or In vitro fertilization and embryo transfer (IVF-ET) failures.
Reproductive immunology
The mother’s immune system plays a very important role in early pregnancy. As the embryo has a different genetic make-up to the mother, it is essentially an outsider. Our immune system in generally programmed to target and remove any cells that do not belong to us or are abnormal. However, in an interesting twist of nature, this same immune system is required to facilitate the changes that the uterus needs to undergo in order to allow for an embryo to implant. The balance between the various parts of the immune system is therefore critical for successful implantation, but not rejection, of an embryo. It has been suggested that some women’s immune systems recognise and target an embryo as foreign cells, using the body’s natural defence mechanism to destroy it. A number of blood and uterine immune cells have been implicated such as uterine Natural Killer cells (uNK), peripheral Natural Killer cells (pNK), T-cells (helper, regulatory and cytotoxic), macrophages and dendritic cells. Although we can offer tests to establish the activity levels of these cells, it is not yet fully understood how exactly they may be playing a part in your infertility. The proposed treatments for these are even more unclear. Therefore, in general, we do not recommend women to undergo reproductive immunological testing until further evidence emerges which can guide our treatments in a more personalised way.
Karyotype and genetic testing
A karyotype is a blood test looking at a woman’s chromosomes, which are the genetic building blocks of life, to try and understand the cause of infertility or repeated losses. In some cases, we might test for specific alterations (mutations) in single genes (which are contained within the chromosomes) to look at any possible genetic mutations that may be passed on to a child. Potentially more emotionally draining than other tests, we are here to counsel you through.
Virology screening
A basic blood test of your immune system to check if you have been exposed, or are immune, to viruses such as rubella, HIV, Hepatitis B and C.