The Fertility Panel is a series of examinations designed to identify the causes of infertility in both men and women, enabling accurate diagnosis and appropriate treatment. Infertility is a reproductive system disorder characterized by the inability to achieve clinical pregnancy after 12 months or more of regular unprotected sexual intercourse (WHO). Approximately 15% of couples experience infertility, with 30% of cases caused by male factors.  

 MALE FERTILITY PANEL:  

Laboratory Examinations:
A. Semen Analysis
Semen analysis is essential, with specimens collected through masturbation. Abstinence from ejaculation for 2–7 days is required prior to the examination. This test evaluates the volume, count, quality, morphology, density, and motility of sperm. Key distinctions include:  
Oligozoospermia: spermatozoa < 1.5 million/ml  
Asthenozoospermia: < 32% progressive motile sperm  
Teratozoospermia: < 4% normal sperm morphology  

B. Anti-Sperm Antibodies 
Sperm contain unique antigens that may be recognized by the immune system if the blood-testis barrier is disrupted due to infection, vasectomy, or trauma. These antibodies can reduce the sperm’s ability to penetrate cervical mucus.  

C. Hormonal Analysis 
Around 3% of male infertility cases are caused by hormonal abnormalities. Tests include FSH, LH, prolactin, and testosterone levels.  

Ultrasonography (USG)
Testicular ultrasound is used to detect varicoceles or abnormalities in the testes. Transrectal ultrasound can examine the prostate and check for semen duct obstruction.  

Testicular Biopsy
A testicular biopsy involves taking a sample of testicular tissue using a needle.  

DNA Fragmentation Index (DFI) Testing  
This test identifies sperm DNA damage levels associated with recurrent miscarriages, varicoceles, leukocytospermia, or failure in assisted reproductive techniques like IUI and IVF.  

FEMALE FERTILITY PANEL:  

Hormonal Testing  
Hormone tests include FSH, estradiol, progesterone, prolactin, AMH, and TSH to identify ovulation disorders such as hypothalamic amenorrhea or ovarian insufficiency.  

Hysterosalpingography (HSG)  
A radiological examination where contrast dye is inserted through the cervix to evaluate the uterine shape and confirm tubal patency.  

Ultrasonography (USG)  
USG assesses the position and size of the uterus, detects fibroids, endometrial polyps, ovarian cysts, and endometriomas.  

Magnetic Resonance Imaging (MRI)  
MRI uses magnetic waves to visualize pelvic masses and detect congenital abnormalities.  

Hysteroscopy  
A procedure to directly visualize the uterine cavity using a hysteroscope.  

Laparoscopy  
A surgical procedure to examine pelvic organs via a small incision in the abdominal wall.  

Endometrial Biopsy  
Tissue sampling of the uterus is performed using a catheter inserted through the cervix.  

Author: Dr. Eriza Dwi Indah Lestari (Medical Consultant at PRAMITA Clinical Lab, Jl. Bambang Sugeng No. A2, Magelang)