Female Infertility Examination: What Tests Should Be Done

The article is professionally consulted by Specialist Doctor II Huynh Thi Hien - Obstetrician and Gynecologist - Department of Obstetrics and Gynecology - Vinmec Nha Trang International General Hospital

Infertility is the inability to conceive in couples who have been together for more than a year, have normal sex, and do not use birth control methods. At that time, both husband and wife need to go to the doctor because infertility can happen in men or in women.

A complete blood count or complete blood count is a test done to assess your overall health for anemia, infection, or leukemia. Specifically, the test says:
Red blood cell count: red blood cells that carry oxygen. White blood cell count: white blood cells with anti-inflammatory function. Platelet count: helps in blood clotting. Hemoglobin: the oxygen-carrying protein in red blood cells. Hematocrit: the ratio of red blood cells to the liquid or plasma component of the blood.

Blood count test is the basic test for infertility cases who want to be treated with in vitro fertilization (IVF). Because when performing in vitro fertilization, surgery is required to remove the eggs, so the doctor needs to know the blood parameters, especially the risk of anemia.

The erythrocyte sedimentation rate test is a blood test to know the level of inflammation in the body. This is not a standalone diagnostic tool, but it can help doctors diagnose the progression of an inflammatory condition. The test blood sample is contained in a tube, the red blood cells will settle to the bottom. The faster the erythrocyte sedimentation rate, the greater the risk of infection.
The faster the sedimentation rate, the greater the risk of infection. Because inflammation causes the cells to clump together, which is denser than the blood of a healthy person. The erythrocyte sedimentation rate and red blood cell spacing are usually measured in a test tube within one hour. This test is essential in diagnosing infertility.

Vegetarians and regular eaters often have different blood sugar levels. This can affect a woman's chances of getting pregnant. Therefore, it is important to check blood sugar and insulin levels to know the risk of infertility.

The VDRL test is a test for syphilis antibodies. This test uses antigens prepared from bovine hearts, which react with the human serum to be tested. If a cotton-like precipitate is seen, the test is positive, it means that the patient has syphilis. Because serum has many different dilutions, the positive level will be expressed by plus signs: +, ++, +++,...
This is a sensitive, easy to do, but specific reaction. not tall. If high specificity is desired, it is necessary to use antigens that are Treponema spirochetes as in the TPI, TPHA reaction. Syphilis does not affect fertility, but if left untreated, it can affect both mother and unborn baby. Therefore, before pregnancy as well as infertility testing should do this test.

This test to know if you are immune to Rubella virus, you do not need an infertility examination. However, most women are already immune to the virus by the time they conceive. Pregnant women carrying the virus in the first 3 months of pregnancy will have many risks to affect the fetus.

Knowing your vitamin B12 or folate levels is important to determine if you are at risk for anemia. Vitamin D3 levels are associated with infertility in women. Therefore, when examining female infertility, it is necessary to do these tests.

T3, T4, and TSH are thyroid hormones. If the levels of these hormones are not within the desired range, it is possible that the thyroid gland is either overactive or underactive, known as hyperthyroidism and hypothyroidism.

Thyroid dysfunction will affect a woman's ovulation and pregnancy. Therefore, this test is very necessary to know the risk of infertility as well as for the group of people with thyroid disease who want to have children.

Endocrine testing is done to survey the functioning of the ovaries as well as the woman's ability to store eggs. At the same time, hormonal testing is also used to monitor follicular development and ovulation. In particular, it is possible to know the level of reproductive hormones, the risk of infertility caused by interference in the ovulation process or inappropriate ovarian reserve.

8.1. Prolactin test

Prolactin is a hormone necessary for maintaining fertility in women. This hormone inhibits reproductive hormones that are follicle-stimulating hormone (FSH) and gonadotropin-releasing hormone (GnRH). These hormones are needed to trigger ovulation, which helps eggs develop and mature.
So if the hormone prolactin is high, it will affect the ovulation process and very easily cause infertility.
8.2. E2 or Estrogen Hormone Test This test is done on the 2nd or 3rd day of your menstrual cycle. The hormone estradiol (E2) or estrogen is an important female sex hormone, produced in the ovaries. The follicles in the ovaries secrete estrogen which triggers the reproductive cycle.
8.3. LH hormone test LH hormone test is also usually done on the 2nd or 3rd day of the menstrual cycle. LH is one of the most important hormones for reproduction. LH levels can be involved in ovulation and the menstrual cycle, increasing the risk of polycystic ovary syndrome leading to infertility.
8.4. FSH hormone test FSH hormone is released from the anterior lobe of the pituitary gland in the brain. In women, the hormone FSH stimulates oocyte development - part of the monthly menstrual cycle. Women with polycystic ovary syndrome (PCOS) often have low FSH levels, which causes failure to ovulate and leads to infertility.

During the menstrual cycle, a woman's FSH levels will vary to varying degrees. The FSH hormone test is done on day 3 of your menstrual cycle. This is an important test for female infertility.
8.5. AMH hormone test AMH hormone is secreted directly from the granulosa cells of ovarian follicles and is directly related to the number of primordial follicles in the ovary. AMH is most abundantly produced in immature and developing follicles in the ovaries. Therefore, the AMH level will indicate the number of immature follicles present in the ovary, or ovarian reserve. The better the ovarian reserve, the higher the fertility of the ovaries. If AMH levels are low, the chances of infertility are high.
AMH concentration is constant, does not change with the menstrual cycle, so it can be done on any day of the cycle. This makes ovarian assessment much more convenient for the patient. Because in the past, tests to evaluate ovarian function (FSH, LH, E2) were required in the early days of the menstrual cycle.
AMH testing plays an important role in the diagnosis and treatment of female infertility, especially before ovarian stimulation for IVF.

These tests not only contribute to the diagnosis of female infertility but are also essential in the treatment of this condition. For accurate examination and advice, customers can go to the Fertility Center for effective treatment support.
Vinmec Reproductive Support Center at Vinmec Times City International General Hospital is a modern center in Vietnam, built and applied a treatment process that combines comprehensive examination, combining both orthodontics and medical care. Obstetrics and gynecology to give the optimal plan for each patient case.
In addition to advanced reproductive support methods, a team of good doctors in the country and the world, with prestige and long experience in the field of infertility have a decisive role in the success of IVF Vinmec:
Dr. Dr. To Minh Huong - Head of Clinical Reproductive Support Unit, Vinmec Times City International Hospital. With more than 30 years of experience working in the field of Assisted Reproduction. Th.S.BS Le Thi Phuong Lan - Head of Reproductive Support Unit, Lab, Vinmec Times City International General Hospital. With 30 years of experience working in the field of Assisted Reproduction. The center is equipped with a system of modern facilities and equipment, ensuring the best conditions for embryo culture such as the ISO 14644-1 international standard clean room system, Labo is designed with one-way, pressure Positive force blowing clean air and mini incubator system.