What tests do I need to have before in vitro fertilisation treatment (IVF)?

In vitro fertilisationis a procedure that is carried out in an embryology laboratory with the aim of obtaining embryos using female gametes (ova) and male gametes (spermatozoa). The ova and spermatozoa can be retrieved from the patients (the patients’ own gametes) or from female and male donors (donated gametes).

There are many different ways of obtaining embryos which facilitate a healthy pregnancy and the birth of a healthy child. This is, of course, the main aim of this process.

We currently have a wide range of techniques and tests that help us to determine the right route for each particular case. However, there is also what we might call an initial or basic analysis that we perform before scheduling assisted reproduction techniques of any kind.

Tests begin with a medical interview which provides us with all the necessary information about the patients’ medical history and the medical history of their family members. Any special tests that are needed are pinpointed during this interview.

If patients have been advised to have IVF using their own ova and sperm, we begin by doing the following tests and checks:

For women:

1. A gynaecological check-up including a smear test and vaginal ultrasound with an ovarian follicle count.
2. Transfer test: we insert a thin and flexible cannula into the cervix so that we can get an understanding of its characteristics (length, hardness and course). It is a painless and quick procedure that provides us with vital information for the embryo transfer that will take place during treatment.
3. A general blood test: haemogram, biochemical test and coagulation.
4. Hormone analysis performed in blood:
   • anti-Müllerian hormone (AMH)
   • Thyroid hormones and others (depending on the data included in the medical history).
5. Blood serology: Hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV) and syphilis. This is a requirement before treatment can begin. Women take a blood test to find out if they are immune to rubella.
6. A mammogram is performed on women over 40 years of age if there is no associated personal background or cases of this illness amongst family members. It is performed from 35 years of age in women who have first degree family connections to issues of this kind.

For men:

1. Semen analysis
2. Blood serology: Hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV) and syphilis.

In both men and women, the need for a karyotype analysis (to check if the chromosomes each person has are normal or abnormal) will depend on their personal background and the background of family members (pregnancy losses, implantation failure, previous foetuses or newborn babies that had malformations associated with chromosomal abnormalities, very young women with poor ovarian reserve, men with serious abnormalities in semen quality and so on).

Because of the huge range of backgrounds in the people who request or need treatment of this kind means that we need to be rigorous when planning, both in terms of our analysis and in terms of the options for each case. NO TWO PEOPLE ARE THE SAME AND NO TWO COUPLES ARE THE SAME. Therefore, based on the results of the basic or initial analysis, appropriate concrete decisions can be taken and any necessary additional tests or check-ups can be performed.

Progress in medicine, biology and technology has meant that the reproductive medicine of the present is interdisciplinary and based on experience, research and applying what has been learnt in a number of fields of science so that personalised treatment can be provided and results can be optimised.

Dr Lydia Luque, a gynaecologist at Instituto Bernabeu.