Infertility Cause Investigation
Couples who are unable to conceive naturally after regular unprotected intercourse for 6 months to 1 year or more may be experiencing infertility. Infertility affects approximately 15% of couples, or about 1 in 6. It is recommended that both the male and female partners undergo medical evaluation to determine the causes and appropriate treatment options.
Semen Analysis
This is a basic diagnostic test used to determine male infertility factors. A semen sample obtained through masturbation is examined to assess sperm volume, concentration, motility, and morphology.
Pre-Test Recommendations
Get enough rest and avoid testing when feeling unwell.
Inform the clinic in advance if you are taking any medication regularly.
Abstain from ejaculation for 3–5 days before testing for accurate results.
What Can a Semen Analysis Reveal?
The fertilization potential of the sperm.
Helps determine the appropriate infertility treatment plan.
Provides insight into overall sperm health and guides further correction if abnormalities are found.
Who Should Get a Semen Analysis?
Men who have been trying to conceive naturally for more than 6 months without success.
Those planning to preserve sperm before undergoing chemotherapy or surgery.
Men preparing for assisted reproductive treatment.
Transvanal Ultrasound Scan
This test evaluates uterine and ovarian abnormalities that may contribute to infertility. It can be performed at any time during the menstrual cycle. When performed on day 2–3 of the cycle, it allows observation of antral follicles for that cycle. When done mid-cycle, it helps estimate follicle size to predict ovulation day.
Pre-Test Recommendations:
The uterus and ovaries can be evaluated at any time during the menstrual cycle.
To assess ovulation, testing is performed on days 12–14 of the cycle.
To evaluate antral follicle count, testing is performed on days 2–3 of menstruation.
What Can a Transvaginal Ultrasound Reveal?
Uterine or ovarian abnormalities, such as fibroids (Myoma) or ovarian cysts.
Possible signs of fallopian tube abnormalities.
Follicular development throughout the cycle.
The Anti-Müllerian Hormone (AMH) test measures hormone levels through a blood sample to evaluate ovarian reserve — an indicator of the remaining egg supply. AMH results show whether the ovaries are functioning normally and estimate how many eggs are available, helping assess fertility potential and guiding the physician in optimizing fertility treatment plans.
In IVF treatment, the AMH value helps predict how the ovaries will respond to stimulation medications and determine the appropriate dosage to achieve optimal egg production.
Pre-Test Recommendations:
The test can be done on any day, regardless of menstrual cycle, as AMH is not cycle-dependent.
No fasting or special preparation is required.
AMH Value Interpretation:
> 4 ng/ml: High hormone level — may indicate Polycystic Ovary Syndrome (PCOS).
1–4 ng/ml: Normal hormone range.
0.3–1 ng/ml: Low hormone level — indicates reduced ovarian reserve and higher infertility risk.
< 0.3 ng/ml: Very low level — severely diminished ovarian reserve, likely infertility.
Who Should Take the AMH Test?
Women who want to know their remaining egg count.
Women over 35 years old who have been trying to conceive for more than 6 months.
Women under 35 years old who have been trying for more than 1 year.
Those planning to freeze eggs for future use or before chemotherapy or surgery.
FemVue is a diagnostic procedure that injects saline and air into the uterus while performing a transvaginal ultrasound to observe fluid flow through the uterine cavity and fallopian tubes. This method is less painful and safer than traditional X-ray dye tests (HSG).
Pre-Test Recommendations:
The ideal time for testing is 2–3 days after menstruation has completely ended.
No fasting or dietary restrictions are required before the test.
Advantages of FemVue:
Quick and immediate results.
Lower cost.
Lower cost.
Hysteroscopy is a diagnostic procedure using a small camera (2–4 mm in diameter) inserted through the vagina and cervix to inspect the uterine cavity. It is often performed after ultrasound findings suggest abnormalities, as it provides more detailed visualization of the uterine environment — a key area for embryo implantation and pregnancy success.This procedure offers more comprehensive information than ultrasound, can be performed without anesthesia, does not require hospitalization, and typically takes only 10–15 minutes. It is especially valuable for identifying factors contributing to infertility or recurrent miscarriage.
Pre-IVF Evaluation Checklist
Before starting the In Vitro Fertilization (IVF) process, both partners are required to undergo the following medical examinations and tests.
| Examination | For Female | For Male |
|---|---|---|
| 1. Medical history taking and general physical examination | ✔ | ✔ |
| 2. Vital signs: blood pressure, pulse, weight, height | ✔ | ✔ |
| 3. Transvaginal ultrasound | ✔ | |
| 4. Cervical cancer screening and HPV test (ThinPrep + HPV) | ✔ | |
| 5. Pelvic examination (PV) | ✔ | |
| 6. Complete blood count (CBC) | ✔ | ✔ |
| 7. Blood group (ABO) | ✔ | ✔ |
| 8. Blood group (Rh factor) | ✔ | ✔ |
| 9. Thalassemia and hemoglobin typing | ✔ | ✔ |
| 10. HIV antibody screening | ✔ | ✔ |
| 11. Syphilis screening (VDRL) | ✔ | ✔ |
| 12. Hepatitis B surface antigen (HBsAg) | ✔ | ✔ |
| 13. Hepatitis C antibody (HCVAb) | ✔ | ✔ |
| 14. Rubella immunity (Rubella IgG) | ✔ | |
| 15. Hormonal profile (AMH, FSH, LH, E2, Prolactin) | ✔ | |
| 16. Semen analysis | ✔ |
Infertility Consultation
Takara IVF Bangkok provides consultation for all infertility-related concerns — including ovulation tracking and timed intercourse planning. Couples can combine the consultation with preliminary diagnostic tests during the same visit for convenience and to save time. This allows the consultation and treatment planning to be completed together in a single appointment.