Are you thinking of freezing your eggs? Here are the tests you should have done beforehand 

Initial fertility consultation

The assessment begins with a clinical interview. Before ordering any tests, we need to understand why you wish to preserve your fertility and what your personal and medical circumstances are.

During this initial consultation, we will review:

• Your age.
• The regularity and duration of your menstrual cycles.
• Your gynaecological and reproductive history.
• Any previous surgery on the ovaries.
• Endometriosis, cysts, fibroids or other uterine pathologies.
• Previous or current medical treatments.
• Family history of early menopause.
• Medication, allergies and conditions such as hyperthyroidism.
• Results of any recent tests.

It is also important to know when you would like to start and whether there are any medical or professional circumstances that might affect the timing. With this information, we can decide which tests you need and avoid repeating tests that are still valid.

Transvaginal ultrasound and antral follicle count

At the first consultation, we can already carry out a transvaginal ultrasound, which allows us to examine the uterus and ovaries. During the scan, we count the antral follicles – small ovarian structures containing immature oocytes that can be seen at the start of the cycle.

The count helps to estimate ovarian reserve and the likely response to medication. It also enables us to detect findings that could influence treatment, such as:

• Ovarian cysts.
• Endometriomas.
• Uterine fibroids.
• Anatomical abnormalities.
• Ovaries that are difficult to access for aspiration.
• Signs consistent with polycystic ovary syndrome (PCOS).

Analysis of anti-Müllerian hormone

Anti-Müllerian hormone (AMH) is one of the most commonly used markers for estimating ovarian reserve. Its level helps to predict whether the response to stimulation is likely to be low, normal or high.

This information enables us to determine the initial dose of medication and adjust expectations regarding the likely number of follicles.

However, it is worth clarifying a point that often causes confusion:

AMH levels vary from woman to woman; AMH provides information on the estimated number of oocytes and, together with the antral follicle count, allows us to predict their quality.

Hormone profile

Depending on the individual case, we may request further hormone tests relating to ovarian function, such as:

• FSH.
• LH.
• Oestradiol.
• Progesterone.
• TSH to assess thyroid function.
• Prolactin when clinically indicated.

FSH, LH and oestradiol are usually interpreted taking into account the stage of the menstrual cycle. Not all of these tests are essential for every patient.

For example, in cases of irregular cycles, amenorrhoea or when there are conflicting results between AMH and ultrasound, the hormonal profile can help us to better understand ovarian function.

Serological tests prior to egg vitrification

These usually include serological tests for HIV and hepatitis B and C, although the exact tests carried out depend on the current protocol and the clinical situation.

These tests do not assess ovarian reserve. Their purpose is to ensure safety during the processing and storage of samples in the laboratory.

Pre-operative blood tests and assessment of sedation

Oocyte retrieval is carried out by means of follicular aspiration, generally under sedation. For this reason, pre-operative tests may be requested prior to the procedure, including:

• Complete blood count.
• Coagulation profile.
• Basic biochemistry.
• Anaesthetic assessment.
• Electrocardiogram where indicated.

The tests required will depend on the patient’s age, medical history, the type of sedation and the centre’s protocol.