Few tests are needed before starting the treatment in an Infertile Couple.
1) Semen Analysis of the Husband
2) Wife's Blood test for AMH, Rubella and Thalassemia
3) Wife's TVS to look for the ovaries and the uterus
4) Wife's HSG to look for the Fallopian Tubes.
In majority of the cases, treatment can be started after these tests. ONLY in some cases, further tests are necessary.
Why further tests are often UNNECESSARY?
1) For any disease, we should do the tests ONLY when the test will give important information that is helpful to change the decision for treatment. If a test does not change the decision, it is not helpful.
2) There are thousands of tests. It does NOT make any sense that you have all those and then start treatment.
3) In some cases, the treatment procedure may be expensive. If you spend too much in the tests, it's difficult to carry out the actual treatment.
Let's see different other tests.
You know, it is a type of "Microsurgery" by which a camera is inserted inside the abdomen to look for the uterus and ovaries in the best manner. But it's a major surgery, so it should be done only in few cases like:
A) If both the tubes are blocked. If ONLY ONE TUBE is blocked, there is no need of Laparoscopy.
B) If there is Hydrosalpinx (Swollen Tubes), Large Cysts in the ovaries, Large Fibroids in the uterus or severe pain during menstruation.
Therefore, in each and every case of Infertility, Laparoscopy is NOT NEEDED.
It involves inserting a camera to see inside the uterus. It's also a surgery and therefore should ONLY be done, if there are
A) Abnormal bleeding, polyps or Fibroids inside the uterus or birth defects
B) In some cases of repeated IVF Failure.
So, Hysteroscopy is not Essential in each case of Infertility.
It involves testing of some organisms like Toxoplasma, Rubella, Cytomegalovirus, Herpes and Syphilis. Previously the test was done if there was Repeated Miscarriage.
Now it has been scientifically proven that TORCH cannot cause repeated miscarriage. These infections cannot cause Infertility. Therefore, TORCH test is UNNECESSARY.
Only case, where the TORCH testing is necessary, in the previous pregnancy, the baby died inside the uterus and no cause was found.
However, Rubella test is necessary to prevent this infection affecting your baby.
Antiphospholipid Antibody (APLA) testing-
It involves testing for Lupus Anticoagulant, Anti Cardiolipin and Anti beta 2 glycoprotein. These are essential if you had previous repeated miscarriage.
But if you did not have previous repeated miscarriage, testing for APLA is unnecessary and is the waste of money.
It means a blood test to check for the chromosomes. It is needed only in few cases:
A) In a man with very low sperm count or Azoospermia and the testicles are not functioning.
B) In a women with early menopause.
C) In a couple with previous repeated miscarriage or previous baby with chromosomal abnormalities.
In other cases, this test is not necessary.
This means testing the semen for infection. This is needed only if there is suspicion of infection in the husband (pain or abnormal discharge, some cases of abnormal semen).
Therefore, we can start treatment of Infertility only after few tests.