Every patient is assessed before beginning any assisted reproductive technique. This is done to maximize her possibilities for success and a healthy conception. For attaining pregnancy with IVF, it is vital to have good preconception health. Regular monitoring of long-term health conditions like asthma, high blood pressure, and diabetes must be done before planning conception. Females must have an optimized weight before planning an IVF cycle. Obesity greatly lowers down the success of IVF treatment and enhances the risk of complications such as miscarriage and preterm birth.
• Before beginning an IVF cycle, the blood type of the female must be verified, and screening for conditions having an impact on her pregnancy must be done.
• A blood test is also needed in documenting the female’s immunity to Rubella and Varicella (Chickenpox). If immunity is absent, then proper vaccination must be done.
• Also, testing for HIV, Hepatitis B and C, and syphilis must be done on the female as well as her partner.
Ovarian Reserve Testing
• With aging, the conception ability of females reduces and the risk of miscarriage also increases.
• Ovarian reserve can be defined as the reproductive potential of the ovaries. It indicates the number of existing egg cells to get fertilized potentially.
• Ovarian reserve can be evaluated by using serum tests or ultrasonography.
• A reduced ovarian reserve indicates the future response to ovarian stimulation (use of fertility drugs to induce ovulation).
• The ovarian reserve test is a good indicator of response to ovarian stimulation; however, false outcomes do not essentially predict the failure in attaining a live birth.
Anti-Mullerian Hormone Test (AMH):
• During the menstrual cycle, the levels of AMH remain moderately stable. The levels can be examined on any day of the menstrual cycle.
• An AMH value below 1.3 is an indicator of a low response to ovarian stimulation.
Day 2-5 Levels of Follicle-stimulating hormone (FSH) and Estradiol:
• FSH values above 10 IU/L signify a low response to ovarian stimulation.
• Estradiol interprets FSH results significantly.
• The estradiol levels must be below 60 to 80 pg/mL; an increase in the estradiol levels suppresses the effect on FSH levels and shows a reduced ovarian reserve.
Ultrasonographic assessment of the antral follicle count:
• This test is used for determining the number of follicles measuring 2 to 10 mm in both ovaries.
• If 5 to 7 follicles are present, this indicates low antral follicle count. And it is also linked to a poor response to ovarian stimulation.
Semen analysis is the microscopic examination of the shape, number, and movement of sperm. It is done on the freshly ejaculated semen in a laboratory. Male infertility can be diagnosed using this analysis.
• The examination of the uterus is performed prior to an IVF using three methods: hysteroscopy, hysterosalpingogram, or a saline infusion sonohysterography.
• Before going for an IVF, a trial transfer can be done for determining the length and direction of the uterus. This helps the doctor in predicting any problems with the embryo transfer.
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