Pre IVF testing

Pre‑IVF Testing: A Comprehensive Guide to Pre‑Treatment Checks for Women and Men

Why Is Pre‑IVF Testing Important?

In vitro fertilisation (IVF) is a multi‑step process that combines hormone therapy, surgery and laboratory techniques to help people conceive a child. A comprehensive assessment before starting IVF ensures that your body is ready for treatment, identifies any underlying conditions that could affect fertility, and allows your doctor to tailor the protocol to maximise your chances of success. According to fertility experts, early evaluation is recommended, especially if you are over 35 or have been trying to conceive for six months or more without success.

Our clinic offers a complete range of diagnostic services to support your IVF journey. Below we outline the key tests performed before IVF, categorised into tests for women and tests for men. Many of these evaluations are standard recommendations from international fertility clinics and medical societies.

Pre‑IVF Tests for Women

1. Infectious‑Disease Screening

Protecting both the mother and future baby from infectious diseases is paramount. Your doctor will order blood tests to check for:

• HIV, Hepatitis B & C and syphilis: Screening detects HIV‑1/2, hepatitis B surface antigen (HBsAg and HBcAb), hepatitis C antibodies and syphilis (VDRL or RPR). Positive results require treatment before starting IVF but do not necessarily exclude you from treatment.
• Rubella and Varicella (German measles and chickenpox): Determining immunity is important to prevent infection during pregnancy; vaccination may delay the start of treatment by a month or two.
• Gonorrhoea and Chlamydia: These sexually transmitted infections can affect fertility and must be treated prior to IVF.

2. Hormonal and Ovarian Reserve Tests

Assessing ovarian reserve helps your doctor choose the right stimulation protocol. Common tests include:

• Anti‑Müllerian Hormone (AMH): Indicates the remaining egg supply. Low values suggest diminished ovarian reserve, whereas high values may indicate polycystic ovary syndrome (PCOS).
• Follicle‑Stimulating Hormone (FSH) and Luteinising Hormone (LH): Measured on day 2–5 of your cycle to evaluate how your body responds to fertility drugs.
• Estradiol (E2): Helps interpret FSH results and provides additional information about ovarian function.
• Thyroid Stimulating Hormone (TSH) and Prolactin: Thyroid and prolactin imbalances can interfere with ovulation and implantation; correcting them improves fertility.

3. General Blood Tests

To ensure overall health and detect underlying conditions, you may undergo:

• Complete Blood Count (CBC): Checks for anaemia or infection.
• Blood Type and Antibody Screen: Determines compatibility for both partners, which is important if blood groups are incompatible or if a donor is involved.
• Kidney and Liver Function Tests (Creatinine, BUN, ALT, AST) and Fasting Glucose: Provide a baseline of organ function, as certain fertility medications can affect these systems.
• Vitamin and Nutrient Levels: Folate (folic acid) and vitamin B12 to detect deficiencies.

4. Imaging and Structural Tests

• Transvaginal Ultrasound: Counts the antral follicles in your ovaries and checks for ovarian cysts or uterine abnormalities.
• Hysterosalpingography (HSG) or HyCoSy: These tubal patency tests use contrast agents during an X‑ray or ultrasound to determine whether the fallopian tubes are open. Blocked tubes may indicate a need for IVF or laparoscopic surgery.
• Hysteroscopy or Sonohysterography: Endoscopic procedures that assess the uterine cavity for polyps, fibroids or scar tissue (synechiae). They are particularly useful for women with unexplained infertility or repeated implantation failure.
• Mock Embryo Transfer: A trial transfer using a soft catheter to map the cervix and uterus. It helps the doctor determine the ideal insertion path and is performed before the actual embryo transfer.

5. Genetic and Immune Testing

Some patients require additional genetic or immune assessments:

• Cystic Fibrosis Carrier Screening and Hemoglobin Electrophoresis: Detect carrier status for conditions like cystic fibrosis, thalassaemia, sickle cell disease and other haemoglobinopathies.
• Karyotype Analysis and Fragile X Testing: Recommended if there is a history of chromosomal abnormalities or repeated miscarriages.
• Immune Panel: Tests for antiphospholipid antibodies, lupus anticoagulant, thyroid antibodies and other markers that may contribute to recurrent pregnancy loss.

Pre‑IVF Tests for Men

Infertility is equally attributable to male factors. A thorough evaluation improves the selection of treatment options, whether IVF, ICSI or surgical sperm retrieval.

1. Infectious‑Disease Screening for male

The male partner will undergo the same infectious‑disease tests as the female partner, including HIV, hepatitis B and C, syphilis, gonorrhoea and chlamydia. These tests ensure the safety of the pregnancy and the lab environment.

2. Semen Analysis and Advanced Sperm Tests

• Semen Analysis (Spermogram): Measures sperm count (concentration), motility and morphology to identify oligozoospermia (low count), asthenozoospermia (poor motility) or teratozoospermia (abnormal shape). Our andrology lab also assesses volume, pH, viscosity and vitality.
• Sperm Culture: Detects bacterial infections in semen, which can impair sperm quality and require antibiotic treatment.
• Hormonal Profile: Evaluation of testosterone, FSH and LH to detect endocrine disorders. Elevated FSH and LH with low testosterone may indicate testicular failure.
• Genetic Testing: Karyotyping and Y‑chromosome microdeletion analysis may be recommended in cases of severe oligospermia or azoospermia.

3. Other Evaluations

• Physical Examination: An andrologist checks for varicocele, testicular volume and any anatomical abnormalities.
• Lifestyle Assessment: Smoking, obesity and exposure to toxins can affect sperm quality. Our team offers lifestyle advice to improve outcomes.

Timing of the Pre‑IVF Work‑Up

The timing of investigations depends on your age and history. Women under 35 should consider testing after 12 months of unsuccessful attempts, while those over 35 should initiate evaluation after 6 months. Early assessment allows for prompt treatment and may uncover issues that can be corrected before attempting IVF.

What Happens After the Tests?

Once your results are available, your doctor will review them with you and design a personalised treatment plan. Depending on your diagnosis, this may include:

• Ovarian stimulation using customised hormone doses for the female partner. Learn more about our protocols on the page Stimulation of the Ovaries.
• Egg retrieval performed under sedation, detailed on our Egg Retrieval page.
• Fertilisation by IVF or ICSI, depending on sperm quality; see Fertilization: IVF and ICSI.
• Embryo transfer, the final step where a healthy embryo is placed into the uterus; read about it on our Embryo Transfer page.
• Preimplantation genetic diagnosis (PGD) or PGT to screen embryos for genetic disorders, discussed on the Preimplantation Genetic Diagnosis page.
• Embryo freezing for future use or to preserve fertility; details are available on our Embryo Freezing page.

Our team will also counsel you on lifestyle modifications, nutrition and supplementation to optimise the conditions for a successful pregnancy.

Conclusion

Pre‑IVF testing is the cornerstone of a successful fertility treatment. By identifying potential problems and tailoring your protocol, these tests increase the likelihood of a healthy pregnancy and reduce the risk of complications. At Dr Aksoy IVF, we combine international best practices with state‑of‑the‑art technology to provide comprehensive care. Contact us to schedule your pre‑IVF evaluation and take the first step toward growing your family.