This test is carried out to evaluate possible reasons for infertility which is defined as “failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.”1 Both male and female have been attributed equal possibility of such reproductive disorder. In female the following diagnostic test help identify and treat possible cause of infertility.
• ASAB (Antibody Sperm Antibody) Total
• Blood Group
• Blood Sugar Fasting
• Blood Sugar Post Prandial
• Blood Urea Nitrogen
• Chlamydia Trachomatis IgA Antibodies (Serum)
• Chlamydia Trachomatis IgG Antibodies (Serum)
• FSH (Follicle Stimlating Hormone)
• LH (Leutinizing Hormone)
• Prolactin
• FT3,FT4,TSH
• AMH
• DHEAS
• What does the test help you decide?
The test is used to check for abnormal values of the factors mentioned above.
The factors are as follows:
• AsAb (Antisperm Antibody) Total:
AsAb test identifies antibodies in blood, vaginal fluid, and or semen that act against sperm.4 Antisperm Antibodies (ASAs) act by blocking sperm movement, capacitation, fertilization and inhibits embryo implantation, thereby declining chances of spontaneous pregnancy. These have been reported in 25.6% of sera and 20.5% of cervicovaginal secretions of infertile women.5
• Blood Group:
Studies have shown that an incompatibility of the blood groups can affect reproduction (e.g., ABO incompatibility).6,7 Couples with incompatible blood groups experience spontaneous miscarriage or stillbirth more frequently.7
• Fasting Blood Sugar and Postprandial Blood Sugar:
Diabetic and Pre-diabetic conditions has been associated with infertility in women. Polycystic Ovary Syndrome (PCOS) an established leading cause of female infertility, that is known to be featured by insulin resistance accompanied by compensatory hyperinsulinemia. Moreover, women with PCOS have an increased risk of developing type 2 diabetes. Thus, glucose tolerance test is an important evaluation to achieve complete pathological evaluation.
• Blood Urea Nitrogen:
The measurement of blood urea nitrogen is important an important parameter for evaluating renal function. Chronic renal disease causes imbalance in gonadotropin production and other co-morbidities thus affecting fertility and conception.9
• Chlamydia Trachomatis Antibodies (Serum):
Chlamydia is associated with acute Pelvic inflammatory disease (PID), which is an important cause of tubal pathology leading to infertility. In India, about 15-40 per cent of women with cervical chlamydial infections develop PID11, 20% of which become infertile, 18% develop chronic pelvic pain, and 9% have a tubal pregnancy12. More than 50 % of C. trachomatis infection is asymptomatic. Leproscopy is considered as gold standard for tubal disease diagnosis. However, advances in diagnostic science offers noninvasive blood test for detection of chlamydia infection. Modern diagnostic Lab includes detection of both Chlamydia Trachomatis antigen A (IgA) Antibodies as well as antigen G (IgG) Antibodies as integrated part of infertility detection profile, recommended by various studies.10, 11.
• FSH (Follicle Stimulating Hormone):
High levels of serum Follicle Stimulating Hormone (FSH) have been associated with diminished ovarian reserve.12 Hence, FSH level testing plays a big role in both the work up for infertility and monitoring during treatment.13
• LH (Luteinizing Hormone):
The pituitary hormone levels in the serum is an important marker to help identify cause of women infertility.14 LH is necessity for follicle development and oestrogen production, hence, low levels of these hormones may cause anovulation and eventually infertility.15
• Prolactin:
High prolactin levels are associated with anovulation as it may be causing infertility in women directly or indirectly.16 Hence, testing serum levels of prolactin hormone would help in diagnosis and management of female infertility.
• FT3, FT4, TSH:
Hypothyroidism has been correlation well with menstrual disorders, ovulatory cycles, and decreased fertility. Hence, thyroid hormones, particularly thyroid stimulating hormone (TSH) are some of the crucial components to be considered in female infertility testing.
• AMH:
Anti-Müllerian Hormone (AMH) plasma levels reflect the continuous non-cyclic growth of small follicles, thereby mirroring the size of the resting primordial follicle pool. Thus, this test acts as a useful marker of ovarian reserve.
• DHEAS:
Serum DHEAS is a clinically useful indication of adrenal C-19 steroid secretion. When combined with clinical and other hormonal evaluations, its measurement adds an important dimension to the study of gynecologic endocrinology and infertility.
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