Diagnostics and Prevention

We place great importance on diagnostics at our clinics, which is why we offer several tests that can be used as a part of fertility treatment or as prevention. You have the option of a free consultation on the results of every test, either in person or by phone.

Tests as part of infertility diagnostics in women focus on evaluating ovarian function, fallopian tube patency, hormone levels, immunology, genetics and haematology. Men are tested mainly for sperm production, as well as for immunology or their hormonal profile.

Results of tests forming part of fertility treatments are available to patients only after consultation with a physician, because they must be interpreted in the context of other information, which the physician can expertly evaluate. Usually, the consultation automatically takes place during your next clinic visit. If the next clinic visit is dependent on the test results, the physician will arrange a phone consultation with you.

Tests for Women

Preconception Care

Preconception care is a set of diagnostic methods used to determine current fertility status. This test is recommended also as part of prevention – not only for women who are trying to conceive but also for those who plan to have children in the future.

During this test, your hormonal profile (AMH, prolactin, TSH) is obtained from your blood. The hormonal profile can establish the ovarian reserve, i.e., if the woman still has enough time to conceive or if she should rather start a family without unnecessary delay. Ovarian reserve differs in each woman and, in some rare cases, premature ovarian insufficiency (premature menopause) can occur at around 30 years of age. This test will thus provide you with important information to help you make better decisions about your future.

Besides the hormonal profile, your blood is tested for sexually transmitted diseases and you can directly consult our specialists about all results, either in person or by phone.

STD Testing (for ISCARE patients)

This is a baseline sexually transmitted diseases test using a blood sample. Tests are done for hepatitis B (HBsAG), hepatitis C (HCV), HIV and syphilis. Due to capacity restraints, this test is only conducted on patients who are treated for infertility in our clinics.

Full Hormonal Profile (for ISCARE patients)

Hormonal balance is very important for reproductive health. It is also a good indicator and thus provides very valuable information, especially for women who struggle to conceive or those who want to get pregnant later.  Hormones can help establish the ovarian reserve – i.e., the number of viable eggs produced by the ovaries, and therefore how long a woman can expect to remain fertile. While some hormonal levels tell us about fertility levels at a certain time, others depend on the phase of the menstrual cycle. When the measured hormonal levels do not correspond to the phase of the cycle the woman is in, we talk about hormonal imbalance.

This test is done via blood sampling and determines several hormonal levels, specifically: anti-Müllerian hormone (AMH), progesterone, follicle-stimulating hormone, luteinising hormone, thyroid-stimulating hormone, free thyroxine, prolactin, oestradiol and DHEAS.

Folliculometry

This is an ultrasound scan which monitors the growth of follicles containing eggs (oocytes). Two to three days before ovulation, one of the maturing follicles reaches 16 to 18 mm in size – this is called the dominant follicle. The dominant follicle bursts during ovulation and releases an egg.

The scan consists of repeatedly inserting a thin probe into the vagina over several days, in order to monitor the growth of follicles, and to very precisely determine when ovulation starts and whether it occurs in a way that does not pose a barrier to natural conception. If this scan is part of the course of treatment, the patient does not pay extra for it. Your attending physician will give you more precise information.

Genetic Testing of Thrombophilia Mutations

Thrombophilia is a predisposition to increased blood clotting, which can result in dangerous blood clots forming during pregnancy or hormonal fertility treatment. This is why hereditary thrombophilia factors are examined and the results are important when deciding on fertility treatment and pregnancy care. It is useful to know about this predisposition even outside reproductive medicine.

To do the test, a blood sample is taken and then tested for the individual mutations involved in blood clotting. It is possible to test for as many as 4 mutations, with the most important being Factor II (Prothrombin) and Factor V (Leiden). If a thrombophilia mutation is found, it suggests an increased congenital predisposition to blood clotting, making it necessary to implement preventative measures during treatment.

Tests for Men

It is important to abstain from sexual activity before undergoing tests and sperm sampling. This should last at least 2 days, but ideally not more than 3 days. Sperm cells only live for a few days and naturally degrade and decay at the end of their lifespan. The ratio of such sperm cells increases in cases of longer abstinence, which can slightly skew the results. Therefore, it is in no way true that longer abstinence can lead to better results and we definitely do not recommend it.

Preconception Care

Preconception care is a set of diagnostic methods for determining the man’s fertility status. The core of this test is a semen analysis, accompanied by testing for sexually transmitted diseases from a blood sample. This test is also recommended as part of prevention – not only for men who are trying to father a child, but also for those who plan to have children in the future. This test will tell you more about the current health of your sperm cells and, in the case of unfavourable results, search for and remove the cause or start treatment early. In some cases, lifestyle changes and eliminating risk factors is enough; in others, it is necessary to start treatment or undergo surgery.

You have a direct consultation with our specialists about your results, either in person or by phone.

Semen Analysis

This is a baseline laboratory test for a man focused on evaluating ejaculate quality, and the presence and characteristics of sperm cells. This test evaluates attributes such as volume, appearance, pH and the presence of other cells in the ejaculate. Sperm count, vitality, motility and morphology are also evaluated.

The entire test takes place at our clinic and you need to make an appointment in advance. After arriving and registering at reception, you will be called by one of our andrology lab technicians, who will escort you to a sampling room where they will discuss the entire sampling process and arrange the date and form of results consultation. Sampling takes place in a dedicated room using a special sterile container that we will give you. In the room, there is a box and a bell; you will put your sample into the box, then ring the bell. Our andrologists will then know they can take the sample from the other side and start the analysis. The last step is payment at our cash desk.

The referential values of normal semen analysis according to World Health Organisation (WHO) standard, 2021, are:
Ejaculate volume: 1.5 ml minimum
pH: 7.2 – 8.4
Sperm count: 15 million sperm cells/ml minimum
Total sperm motility: 40% minimum
Progressively motile sperm cells ratio: 32% minimum
Morphologically normal sperm cells ratio: 4% minimum

STD Testing (for ISCARE patients)

Your blood is tested for sexually transmitted diseases. Tests are done for hepatitis B (HBsAG), hepatitis C (HCV), HIV and syphilis. Due to capacity restraints, this test is only conducted on patients who are treated for infertility in our clinics.

Sperm DNA Fragmentation Testing

This test uses the Halosperm technique, which helps us determine the percentage of sperm cells with damaged DNA in the ejaculate. This percentage should not exceed 30%. Genetic information in the sperm heads may be damaged even if the sperm cells do not exhibit abnormal morphology or motility. The DNA molecule may be damaged by oxidative stress, creating the breaks which reduce the fertilisation success rate. If a damaged sperm cell fertilises an egg, the created embryo usually divides more slowly, or has lower viability in later development stages. Fortunately, there are several methods by which these damaged sperm cells can be filtered out – e.g., MACS and MFSS methods.

SpermPack – Complex Sperm Testing

The most comprehensive test offered by our clinic also includes antibody testing, vitality testing and Oxisperm in addition to SPG and DNA fragmentation. Immunology testing for antibodies determines the presence of IgG anti-sperm antibodies in the ejaculate. Vitality testing ascertains the ratio of living sperm cells in the sample. Oxisperm is a reliable way of measuring potential excessive free radicals. Oxidative stress is caused by an imbalance between the cell’s oxidative capacity and the quantity of free radicals, which are the product of normal cell metabolism. This then results in cell damage, which may affect male gametes and thus also fertility.

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