IVF procedure

Preliminary testing

When attending an IVF clinic for the first time, the doctor will conduct a consultation. He or she will review in depth the past medical history, conduct physical and internal examination and your doctor may perform a 'dummy' embryo transfer to make sure there is no technical problems with the procedure. The doctor may order some investigations before proceeding with treatment.

These usually include:

• Semen analysis. For men who have difficulty in producing semen samples on demand, the doctor may recommend that semen is produced at a convenient time and then frozen and stored prior to IVF treatment as a 'back up' just in case the male partner is unable to perform on the day of egg collection.
• Blood hormone tests to assess the female partners response to fertility drugs (ovarian reserve). The commonly used tests include baseline levels of FSH, LH, estradiol, inhibin B and anti-Mullerian hormone (AMH). The ovarian reserve tests to date have only modest-to-poor predictive value (Broekmans et al 2006 Human Reproduction).
• Blood test to check for immunity to German measles.
• In some women, hysteroscopy or HSG may be ordered to inspect the uterine cavity.
• Screening for chlamydia infection is usually considered if the patient is at risk.
• Some clinics will require screening both partners for HIV, hepatitis B and Hepatitis C and only accept the couple for treatment if the tests results are negative.
• Transvaginal ultrasound scan for antral follicle count (AFC) and ovarian volume, this have only moderate to poor predictive value for assessing ovarian reserve. In addition Assesssing endometrial thickness, texture and any significant distortion of the uterine cavity by polyp or fibroid which may hinder embryo implantation.

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