The reproductive life of older couples, i.e., women over 35 years old and men over 40 years old, requires a more mature approach to fertility testing compared to younger couples.
Ovarian reserve declines drastically in women over 35 years old, and in men, sperm quality tends to decrease particularly after age >40, with reduced motility, morphology, and increased DNA fragmentation.
A meta-study of 90 studies (93,839 males) published in PubMed , showing a significant decrease in semen volume, motility, and morphology, as well as an increase in sperm DNA damage, with advancing age.
However, apart from age effects, lifestyle can also influence it. Obesity, smoking, alcohol, and pollution worsen sperm quality and increase the risk of miscarriage or genetic disorders in offspring.
Therefore, to ensure that assisted reproduction proceeds smoothly and yields results, the following The Shiro Corporation has summarized 7 Before trying to conceive, fertility tests are necessary for mature couples. . Yuk, check out the detailed explanation below!
1. Consultation & reproductive health history
For an initial consultation, it is usually conducted with a specialist doctor in obstetrics or andrology to gather the patient's menstrual history, pregnancy history, as well as the quality of lifestyle and health of the couple.
The doctor also evaluates risk factors such as PCOS, endometriosis, thyroid disorders, or varicocele in males.
Based on that information, the doctor designed a series of further examinations, including hormones, imaging, and appropriate semen analysis, to detect the cause of infertility and conclude on more personalized treatment.
2. Semen Analysis
Semen analysis is an important initial examination for men to assess sperm count, motility, morphology, and quality.
The quality of male sperm generally significantly decreases above the age of 40, and there is a higher likelihood of DNA fragmentation.
If an abnormality is found, the doctor may continue with hormone tests (testosterone, FSH, LH), a testicular ultrasound, or genetic testing to detect varicocele or genetic abnormalities.
3. Female hormone examination
FSH and estradiol tests are conducted on day 3 of the menstrual cycle, while AMH can be done at any time. AMH accurately indicates ovarian reserve with a decline curve starting from age 24-25 until menopause.
High FSH levels and low AMH indicate ovarian reserve and the rate of menopause, which is important for approaching fertility treatment and intervention.
Hormones such as prolactin and TSH are also checked because imbalance can delay or inhibit ovulation, thus reducing the potential for pregnancy.
4. USG transvaginal & Antral Follicle Count (AFC)
USG transvaginal performed in the early phase of the menstrual cycle shows the number of antral follicles and the condition of the uterus and ovaries. This method is sensitive for detecting cysts, fibroids, polyps, or other structural abnormalities.
In addition, the doctor will also calculate the number of AFC in the ovaries. Because, this number indicates the egg reserve and helps the doctor plan the best procreation method.
5. Hysterosalpingogram (HSG) or Sonohysterogram
This is used to check if the fallopian tubes are blocked or if there are any structural abnormalities. With the help of contrast fluid and X-rays, the doctor can determine the condition of the tubes and the uterine cavity.
For alternatives, a sonohysterogram (ultrasound with contrast fluid) can be chosen if you want to avoid radiation, but still get a clear picture of the fallopian tubes and uterus.
6. Laparoscopy and hysteroscopy
This is usually recommended if previous test results show abnormalities in the reproductive organs. Laparoscopy is performed using a small instrument to view the internal conditions of the abdomen and uterus.
Hysteroscopy is used to directly examine the inside of the uterus, including to remove polyps or small fibroids.
These two procedures can simultaneously serve as actions to correct the found disorder.
7. Sperm DNA Test and Genetic
For men over 40 years old, the sperm DNA fragmentation test can provide a more detailed picture of sperm quality. Sperm with damaged DNA is at higher risk of causing miscarriage or failed implantation.
In addition, if there is a history of recurrent miscarriages, genetic testing can also be performed to check for possible chromosomal abnormalities. This way, options such as in vitro fertilization with the selection of the best embryo can be considered.
That's it, 7 Before trying to conceive, fertility tests are necessary for mature couples. . Hopefully, by undergoing this fertility test, the chances of successful IVF treatment at an advanced age will increase, right!
Male Fertility Test Series That Need to Be Known 6 Types of Female Fertility Tests You Need to Know Types of Fertility Tests You Need to Know Before Trying to Conceive-
Mature couples require more mature fertility testing.
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Meta-studies show a significant decrease in sperm quality with increasing age.
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Lifestyles such as obesity, smoking, alcohol, and pollution affect sperm quality.
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