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Fertility testing: what happens when infertility is investigated?

Dr Tasneem Mohamed, obstetrician and gynaecologist at BioART Fertility Centre, sets out how infertility is investigated and what the first round of tests looks for.

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A fertility investigation is a sequence, not a single test. It usually starts with a history from both partners where applicable, then looks at three questions: is an egg being released, is sperm reaching it in adequate number and quality, and is the path between them open. In practice that means hormone and ovarian reserve blood tests, confirming ovulation, a semen analysis, and an imaging test of the tubes and uterus. Antega's point in surfacing this talk is that both partners should normally be assessed together from the start — a male factor contributes in a large share of couples and is missed when only the female partner is tested. Test names, sequence and timing vary between South African clinics and between the public and private sectors, so treat the specific tests mentioned as an example of a workup rather than a fixed list, and check what your own clinic proposes and why.

Recorded at Fertility Show Africa in 2023. Which tests are done first, and in what order, differs between clinics and between the public and private sectors in South Africa. Our guides set out each test in turn.

Key takeaways

  • A fertility workup normally assesses both partners, not only the female partner.
  • The core questions are ovulation, sperm, and whether the tubes and uterus allow egg and sperm to meet.
  • A normal result does not always give an explanation — around one in four couples is told the cause is unexplained.
  • Ask your clinic which tests it proposes, why, what each costs and how long results take.

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Endometriosis, PCOS and female fertility

Professor Zozo Nene, reproductive medicine specialist at Steve Biko Academic Hospital and the University of Pretoria, explains how endometriosis and PCOS each affect fertility.

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References

  • Fertility Show Africa Expert Talks — https://www.youtube.com/watch?v=TJCO3IVEu8Y
  • Fertility Show Africa 2023 show programme — https://fertilityshowafrica.com/wp-content/uploads/2023/07/FSA-2023-Show-Programme.pdf
  • Southern African Society of Reproductive Medicine and Gynaecological Endoscopy — https://sasreg.co.za

This video was produced by Fertility Show Africa Expert Talks (programme curated with IFAASA and SASREG) and is shared for education only. It is not medical advice and does not replace guidance from your own doctor or fertility clinic. Naming an organisation does not imply a partnership with Antega.