Thursday, October 24, 2013

What fertility tests should couples do before marriage ?



Premarital testing is now becoming increasingly common. This makes sense for genetic diseases such as thalassemia ; and for infectious diseases such as AIDS. If we are going to do medical tests,then why not test for the couple's fertility as well ? Won't this prevent lots of potential problems for the future ?Why should they waste time waiting for a year to find out if they have a fertility problem ? And isn't prevention better than cure ?

In reality, this kind of universal testing to screen for infertility is not a good idea because it will end up opening a can of worms.  For most young couples, there’s no need to do any medical tests to check their fertility before marriage. In fact, this testing could actually be counterproductive and create a lot of unnecessary panic because of false positives or minor abnormalities, which are of no clinic importance. For example, a man may have a low sperm count, but he may still be able to make a baby without any assistance. If he gets a test done and finds out his count is low, he may start panicking unnecessarily. This is why it makes sense for most young couples to assume their fertility is fine, without getting it tested formally.

However, there are certain notable exceptions.

Thus , older women should get their blood tested for their AMH level( www.drmalpani.com/amh.htm) to check their ovarian reserve. This way, they’ll know how much time they have left on their biological clock

Also, women with irregular cycles should get their blood tested for the reproductive hormones, FSH, LH, prolactin, TSH and AMH to find out why they are not ovulating.  This is called anovulation. Read more at www.drmalpani.com/anovulation.htm. The commonest reason for this in young women is  PCOD ( polycystic ovarian disease).
You can read more about this at www.drmalpani.com/pcod.htm.

If a man notices his testes are not present in his scrotum, then he should get his semen tested, to make sure his sperm count is normal.

In medicine,  one size does not fit all, and we need to be careful about what tests we order . Overtesting can be harmful.

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