1. Male & Female Investigations Workup Routine / Prior to IVF

2. INVESTIGATIONS FOR MALE PARTNER

3. Examination
Blood investigations
Complete Blood Count
Blood group
Serology : HIV, Hepatitis B (HbsAg), Hepatitis C
Blood sugar (F) /Glycosylated HB
Hb A2 (Thalassemia profile) – only if female partner is Thal minor

4. Semen analysis a) If normal, within 6 months
Semen analysis at Lifecare Centre
a) If normal, within 6 months
b) If abnormal, within 1 month
If count < 1 mill / ml : counseling for the need for Karyotyping

5. Andrologist consultation for
Semen Count < 5 million
Grossly abnormal motility and morphology
Sexual dysfunction
Azoospermia
a) Trial testicular aspiration /biopsy with
cryopreservation of sample obtained
b) If no sperm is recovered in the tissue, then tissue to
be sent for histopathology
c) Consent for stand by donor sperms in borderline cases
d) Ultrasound of testes to rule out testicular tumor/ any
other pathology (optional)

6. Sperm Vitality test (24 hours)
Semen C/S
Sperm Vitality test (24 hours)

7. Cryopreservation of semen sample :
Poor semen samples (eg 0-1 motile
sperm/HPF)min.of 2 samples to be preserved
b) Patient should be counseled regarding sperm
survival post-thawing (50%)

8. Investigation for Female Partner

9. Blood Investigations Complete Blood Count Blood group
Serology : HIV, Hepatitis B (HbsAg), Hepatitis C
Blood sugar / Glycosylated HB
Hb A2 (Thalassemia profile) –
Rubella IgG

10. R/O Genital koch’s
ESR
Mx Test
Latent TB √
MTBC / PCR √

11. Hormonal Assays Not required as a routine
Long standing esp. unexplained infertility
Clinical examination
Irregular cycles / oligo – anovulation
AMH
FSH,E2 (optional)
TSH, Prolactin

12. Ovary / Endometrium / Cervical Mucus
Prerequisites Female
Healthy endometrium – USG Monitoring
Pre ovulatory scan : > 8mm
Hysteroscopy : if scan abnormal,
- previous implantation failure,
- H/O hysteroscopic surgery,
- Endometrial tuberculosis
Ovary / Endometrium / Cervical Mucus

13. Prequisites Female AFC > 5 antral follicles / ovary AMH : > 2
Ovulation
AFC > 5 antral follicles / ovary
Ovarian volume : length > 28mm
AMH : > 2
FSH (< 10)
TSH, Prolactin

14. Prior to IUI : Tubal Evaluation is must

15. Pre IVF investigations Female :
Suitability for anesthesia
Fitness for pregnancy
Especially for elderly women undergoing egg donation and for surrogates

16. Counseling Procedure Cost Prognosis Psychological - Prior to IVF
- Day of ET
- 1 week after ET

17. Thank You