- So what does a fertility work up involve?
My name is Dr. Fleur Cattrall
and I am a Melbourne IVF Fertility Specialist.
So if you're having trouble falling pregnant,
you'll want to go and see a Fertility Specialist
so we can organize some tests to work out why
you're not falling pregnant.
So if we start with the female,
then we will look at ovulation.
So are you producing an egg?
So to do this,
the Fertility Specialist will ask you
about your cycle length.
So that is the time from your day one,
your first day of period,
until your next day one.
And the textbooks would say that's 28 days,
but it could be 24 days.
It could be 35 days.
It could vary every month.
So leading up to your appointment
with your Fertility Specialist record this.
This will be a good starting point
for discussion about ovulation.
So some women have already tracked through their cycle
and they've done some urine ovulation tests
or they've done some basal body temperature testing
and they can show this to their Fertility Specialist
and this can be a bit of a guide
for the Fertility Specialist on what needs to be done next.
To confirm ovulation
we often will do a blood test about a week
after the egg's been released
or in a 28 day cycle when we think ovulation
happened day 14,
we'll do a blood test day 21.
After ovulation,
the ovulation site becomes a progesterone producing factory
and the progesterone gets the lining of uterus
ready for pregnancy.
So doing the blood test a week after ovulation
can confirm that the progesterone is rising,
ready for implantation.
The other thing that the Fertility Specialists will look at
is your heaviness or your pain of your periods.
Now this is hard to know if it's normal,
but first day of period,
a little bit of period pain relieved with simple pain relief
is probably normal,
but if it's quite severe,
you need time in bed,
you have very, very heavy periods,
then this is the clues that the Fertility Specialists
will be looking for.
So the next step after taking a history
and will be to organize a pelvic ultrasound,
and this will look at a female's anatomy.
Do they have a normal uterus?
Do the have normal ovaries?
So on the ultrasound we'll be looking for things like
is the lining of the uterus normal?
Are there any polyps?
Which has an overgrowth of the lining of the uterus.
Is there overgrowth of the wall of the uterus
called a fibroid?
We'll also be looking at the ovaries.
The ovaries sometimes contain ovarian cysts
which can prevent couples fall pregnant.
The other thing we look at is the ovarian reserve.
Now we do that with both the ultrasound,
looking at the ovaries,
and we look at what's called the antral follicle count.
So this is a baseline egg number,
and we'll be counting these in each ovary.
And we also look at the ovarian reserve
in the form of a blood test
called the anti-mullerian hormone.
Anti-mullerian hormone is released from the total pool
of eggs in the ovaries
and gives us a bit of a guide of your ovarian reserve.
So the ultrasound and the anti-mullerian hormone
together will tell us whether your egg numbers
are normal for your age, low or high.
They don't however tell us about egg quality.
We'll be looking at your female age to give us a guide
on egg quality.
Now the other thing that we think about with women is
is there a pathway for the sperm and the eggs to meet?
Now we do this by looking at your anatomy on the ultrasound
and we're looking at the fallopian tubes,
but the fallopian tubes are really hard to see
on a basic ultrasound.
So we need to take the next step.
And your Fertility Specialists
may recommend to you a further test
to put some fluid through the fallopian tubes
to confirm that they're open and not blocked.
This can be done in the ultrasound department
where a speculum is put in,
a bit like having a pap smear
and then a little catheter is put through the cervix
and fluid is put through to confirm that pathway is open.
For men we look at the semen analysis.
Now this is a classic test to confirm male,
men are fertile.
On this test we're looking at the count,
the quality, the movement and the shape,
and we also look for anti-spam antibodies.
So there you go,
there are the initial steps
that a Fertility Specialists will take
to do a fertility work up.
When you come back to see your Fertility Specialist
they will have all the results for you
and then we'll go through them and work out
if there's any other tests that we need to do.
Thanks for watching.
I hope this video was helpful for you.
Good luck on your fertility journey
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Take care and have a good day.