Topics
Hormonal Imbalances
Hormonal issues are a common cause of infertility in both men and women. These imbalances can disrupt ovulation, sperm production, and overall reproductive health. Tests to uncover these problems at Gleneagles Hospitals that are able to provide some answers to the cause of infertility.
Blood tests for hormone levels
These tests measure key hormones like follicle-stimulating hormone (FSH), luteinising hormone (LH), oestrogen, progesterone, and testosterone. Abnormal levels can indicate issues such as polycystic ovary syndrome (PCOS) or low testosterone levels.
Thyroid function tests
Thyroid disorders can interfere with women infertility of their ovulation and male sperm production. Testing for thyroid-stimulating hormone (TSH) levels can help identify hypothyroidism or hyperthyroidism.
Prolactin tests
High prolactin levels can suppress ovulation and cause irregular menstrual cycles.
Addressing these imbalances with tailored treatments such as hormone therapy or lifestyle changes can improve fertility outcomes significantly.
Diagnosis Test to Take for Structural Abnormalities
Structural issues within the reproductive system can also hinder conception. Diagnostic tests for structural problems include:
Ultrasound imaging
Used to identify abnormalities like uterine fibroids, ovarian cysts, or endometrial polyps.
Hysterosalpingography (HSG)
A specialised X-ray that evaluates the fallopian tubes and uterus for blockages or scarring.
Laparoscopy
A minimally invasive surgical procedure to detect endometriosis, adhesions, or other pelvic abnormalities.
These tests help in diagnosing physical barriers to conception, many of which can be treated surgically or with assisted reproductive technologies like in (IVF) vitro fertilisation (Thaker et al., 2023).
Male Factor Infertility
Infertility affects men and women equally, yet male infertility is often overlooked. Comprehensive testing for male factor infertility includes:
Semen analysis
There are some factors to evaluate that can be, first the quantity of the sperm count, secondly the motility that is movement. To reach and fertilise an egg, thirdly morphology is the shape and size of the sperm. This is often the first step in identifying male infertility.
Hormonal evaluations
Blood tests for follicle stimulating hormone(FSH), luteinising hormone (LH), testosterone, and prolactin to detect hormonal deficiencies.
Genetic testing
Identifies chromosomal abnormalities or genetic conditions like Klinefelter syndrome that may impact fertility.
Testicular biopsy
A procedure to determine sperm production directly from the testes in cases of azoospermia (no sperm in ejaculate).
By addressing male-specific issues through medical interventions, lifestyle changes, or assisted reproduction, couples can significantly increase their chances of conceiving (World Health Organization, 2024).
Unexplained Infertility
For approximately 10–20% of couples, standard fertility tests such as hormonal profiles, tubal patency tests, and semen analysis may return normal results, yet conception remains elusive. This condition is referred to as unexplained infertility. In these cases, more advanced diagnostic tools can help uncover hidden factors contributing to infertility and provide crucial information for personalised treatment strategies. These specialised tests include:
Genetic Screening
Genetic factors can subtly influence fertility without causing overt medical conditions. Genetic screening involves analysing both partners' chromosomes and specific gene mutations to detect abnormalities that may affect egg or sperm quality. Conditions such as balanced translocations, single-gene mutations, or mitochondrial DNA defects may impair embryo development, lead to implantation failure, or increase the risk of miscarriage. Detecting these abnormalities can guide clinicians to recommend appropriate interventions, including preimplantation genetic testing (PGT) during IVF cycles.
Reproductive Immunology Testing
In some cases, the immune system may play a hidden role in unexplained infertility. Reproductive immunology testing evaluates whether autoimmune or alloimmune responses are present, which could hinder embryo implantation or cause recurrent miscarriages. Conditions like antiphospholipid syndrome, elevated natural killer (NK) cell activity, or the presence of anti-thyroid antibodies may contribute to failed pregnancies. Identifying these immune factors allows fertility specialists to incorporate immunomodulatory treatments, such as corticosteroids, intralipids, or anticoagulants, to improve the chances of a successful pregnancy.
Endometrial Receptivity Analysis (ERA)
A receptive endometrium is critical for successful embryo implantation. However, even in healthy women, the optimal timing for implantation (the "window of implantation") can vary. ERA involves a biopsy of the endometrial lining, which is then analysed for gene expression patterns that indicate receptivity. If the window is displaced, clinicians can adjust the embryo transfer timing during an IVF cycle to match the personalised implantation window, significantly improving implantation and pregnancy rates in women with unexplained infertility.
Advanced Semen Analysis
Conventional semen analysis mainly focuses on sperm concentration, motility, and morphology. However, these parameters do not always reflect sperm DNA integrity, which plays a vital role in embryo development and viability. Advanced semen testing includes DNA fragmentation analysis, which assesses the degree of genetic damage within the sperm. High levels of DNA fragmentation have been associated with poor fertilisation, poor embryo quality, and recurrent miscarriage. Identifying this issue can prompt recommendations for lifestyle modifications, antioxidant therapies, or assisted reproductive techniques like ICSI (intracytoplasmic sperm injection) to improve outcomes.
These advanced diagnostic options provide valuable insights that are often missed with standard evaluations. By uncovering underlying genetic, immunological, endometrial, or sperm-related issues, fertility specialists can design more tailored treatment plans, increasing the likelihood of achieving a successful pregnancy, even in cases previously labelled as "unexplained." (Practice Committee of the American Society for Reproductive Medicine, 2020)
Book an Appointment at Gleneagles Hospitals
Infertility can be an emotionally and physically challenging journey, but the right diagnostic tests can uncover hidden causes and pave the way for effective treatments. Gleneagles Hospital offers state-of-the-art facilities and a compassionate team of specialists to guide you through every step of your fertility journey. Book an appointment today to take the first step towards achieving your dream of parenthood or you may also download the MyHealth360 application from the Google Play Store or Apple App Store.