The most commonly advised hormone tests for men are TSH( Thyroid hormone), FSH, LH, Estrogen,Testosterone and Prolactin levels.
For Who? – men with low sperm parameters , azoospermia or clinical suspicion of hormonal disorders
Semen Analysis and semen culture
Semen analysis is the first step in the evaluation of male infertility. this test involves examination of the semen sample with an abstinence period of 2-3 days .the semen volume , appearance, PH, LIQUEFACATION, sperm number, type and percent of movement , shape and size of the sperm are evaluated under a microscope. Semen is evaluated for presence of any infections by performing a cult and sensitivity test when suspected.
The normal semen parameters according to WHO 2010 GUIDELINES ARE;
- PH- 7.2 to 8.0
- Semen volume – 1.5 ml – 6 ml
- Sperm concentration – 15 mill/ml
- Total sperm count per ejaculate- 39 mill/ ejaculate
- Total motile sperm (progressive + non-progressive) – 40%
- Normal morphology – 4%
- Vitality – 58%
CASA(computer assisted semen analysis)
This is an automated or semi-automated technique of semen analysis which gives more accurate, fast and reproducible results and eliminates the inter-observer variation
Tests for Ovulation
- The tests for ovulation are done to determine the time of ovulation and the most fertile period of a menstrual cycle in order to maximize the chances of achieving pregnancy.
- Ultrasound scan – the development and growth of one or more follicles ( which contains the egg ) can be done through serial ultrasound scans beginning from the 2nd – 3rd day of the cycle or a little later till an evidence of ovulation is seen and the couple is advised to have timed intercourse or planned for IUI as per the needs of a patient.
- Serum LH test – LH ( luteinizing hormone ) is Ordinarily, secreted at very low levels throughout your menstrual cycle. But once a developing follicle reaches a certain size — usually around the midpoint of your cycle — LH secretion surges to really high levels. This hormone surge is what triggers ovulation about 24 to 36 hours later.
- Ovulation occurs 24–56 h after the onset of the spontaneous LH rise, with an average of 32 hrs
- A blood test can detect the rising levels of LH HORMONE .the testing can be done once the follicle reaches a mature size which can be detected by a scan.
OVULATION HOME KITS FOR TESTING
LH SURGE
This test allows the woman to know if her ovulation process has started by TESTING HER URINE with help of an LH TEST STRIP . detecting a color change on the LH STRIP INDICATES The LH SURGE ( RISE) .
-the DETECTION LEVEL of the these kits is 20-25 MIU which is near to peak surge
-TESTING is advised Daily from day 10 in a 28 day cycle till one see’s a color change on the strip . If it’s a 30 or 32 day cycle , testing starts from 2-4 days later.
The advantages and disadvantages of home LH testing
PROS
Ease of home testing, Low cost and Non-invasive .
CONS
(chronic serum concentrations near these levels; for these
False-negative results may occur in up to 23% to 35% of ovulatory cycles
False positive results PCOS and premenopausal patients patients- LH levels drops below 20 miu a day before rising
False-negative results – may occur in up to 23 to 35% of ovulatory cycles
False positive results – PCOS and premenopausal patients. (chronic serum concentrations are usually near the detection levels in them.for these
patients- LH levels drops below 20 miu a day before rising.)