Pre-Cycle Tests

HIV
There are four reasons for performing this test:

• Pregnancy may have a negative impact on the health of an HIV+ woman.
• There is risk of transmitting the HIV virus to a child during childbirth and you should be aware of your risk prior to becoming pregnant.
• Although unlikely, there is a theoretical risk of frozen embryos / gamates transmitting the virus to other patient’s embryos/gametes. So to protect all patients, we test everyone before creating embryos.
• The Cayman Fertility Center staff handle body fluids from a large population on a daily basis. Although we always use protective measures to be safe, we would be required to take special precautions with samples from HIV positive patients.

 

Hepatitis B and C
Hepatitis has similar risks to HIV. Hepatitis is more infectious than HIV, although the death rate is much lower. Both partners should be tested. These tests are also of vital importance for the freezing of couples gametes and embryos.

Ovarian Reserve (AMH) blood Test
An AMH test gives us some insight into the remaining quantity of eggs. The AMH test is useful if you have been trying to conceive for over six months, and want to check your ovarian reserve is appropriate for your age. The AMH level can also be used to determine what medication regimen may work best for you.

 

Ultrasound Scan

A vaginal ultrasound at Cayman Fertility Center, or a diagnostic center, is required. The reasons for the ultrasound are to:

• Determine if there are any physical characteristics of your reproductive tract, such as fibroids or polyps that may effect your cycle. The ultrasound also checks for the presence of ovarian cysts and can assess the ease of ‘access’ to your ovaries, as your eggs will be collected using an ultrasound-guided method
• Provide a ‘baseline’ report that can be used as a reference during your treatment cycle
• Measure the size of your ovaries and count the number of small follicles present in your ovaries, called and “antral follicle count” or “AFC”. This can be used like the AMH level to assess your chances of responding to the fertility medications.

Occasionally you may need other ultrasounds done prior to treatment cycles. Most women find a vaginal ultrasound to be a relatively painless and simple procedure. The woman’s partner or a support person can be present during the procedure if you wish. An empty bladder is required for this procedure.

There is an additional ultrasound test often recommended called a “saline infusion sonohysterogram” or “SIS”. This is a specialised ultrasound to determine the shape of the inside of your womb before an embryo transfer. This can be performed at CFC.

Semen Analysis

The semen analysis is a method to determine how many moving and properly shaped sperm are in a man’s ejaculate. This typically involves masturbation and ejaculating into a collection cup. A lab that has experience in the test then analyzes the sample.

Before IVF, two semen analyses are required. At least one semen analysis should be performed at the Cayman Fertility Center laboratory prior to egg retrieval. These analyses may include tests for sperm antibodies in the semen and checks for possible infection that may affect fertilization. Details on collection of the sample will be given to you when you make your appointment. Your GP might have already sent you for a semen analysis as part of your initial investigations, but it is important that this test is repeated at Cayman Fertility Center’s laboratory as test results can vary between laboratories and also over time. Our laboratory also does a detailed preparation to determine what the best technique for preparing your sample is.

 

Semen Production

For some men, providing a semen sample on the day of egg collection can be quite embarrassing and stressful. We endeavor to make this event as easy as possible for you.

It is important to remember that the personnel who will be dealing with you and your sample are doing their normal day’s work and, although it may not seem so to you, find it quite common-place.

There are alternatives to producing your sample at the Clinic. The sample may be produced off the premises and brought to the Clinic in the appropriate sterile container (as long as the time to travel is within one hour).

The sample does not need to be produced by masturbation. Your partner may accompany you and special condoms can be provided to collect your sample.

Often when men are anxious and having difficulty producing a sample, a couple of hours break (i.e. walk or a movie) may help. Please inform our staff, so that they can adjust their laboratory schedule.

Cayman Fertility Center also has the ability to freeze your sperm. It could be used as a back-up to prevent any problems occurring on the day of your partner’s egg collection.

It should be noted that sperm freezing may reduce the motility of your sperm and ICSI may then be required.

Please do not hesitate to discuss any aspects of this with the Nursing staff.

 

Additional testing for men includes blood tests for HIV, hepatitis B and C, just as listed above for women.