Modern Techniques in Diagnosing and Treating Infertility

New Technology in Diagnosing and Treating Infertility: What Has Changed, and Why Your Doctor Must Keep Learning

In short: Infertility care has changed a great deal: blood tests and 3D ultrasound now measure ovarian reserve, genetic tests explain many cases of male infertility, artificial intelligence can find rare sperm in samples once thought empty, and the first global WHO guideline on infertility was published in November 2025. Some new tests are valuable; others are sold without proof. A specialist who keeps learning offers the couple a faster diagnosis, the right treatment from the start and fewer unnecessary procedures.

About one couple in six faces difficulty conceiving. Twenty years ago, many of them were told “everything is normal, just keep trying” or went through long rounds of tests and surgery. Today, modern tools allow a clearer answer, sooner. But the value of these tools depends on a doctor who knows when to use them, how to interpret them and when to say that a test will not change anything.

What has changed in diagnosis

Ovarian reserve: a clearer picture of the egg supply

The AMH blood test and the count of small follicles on ultrasound give a good estimate of how many eggs a woman has left. This helps decide whether a couple can keep trying naturally or should move to treatment sooner, and how to dose the medication if IVF is needed. Our article on [ovarian reserve](/ovarian-reserve/) explains these tests. AMH measures quantity, not egg quality, and it cannot predict the exact date of menopause.

Gentler tests of the tubes and the uterus

Office hysteroscopy, done with a very thin camera often without general anaesthesia, lets the doctor see and treat problems inside the uterus such as polyps. The fallopian tubes can be checked with an ultrasound test using a special foam or contrast fluid, which avoids X-rays. 3D ultrasound shows the shape of the uterus in detail and can reveal a septum or other anomaly without surgery.

The man: from a single semen test to a full assessment

Male factor is involved in about half of infertile couples. Computer-assisted semen analysis gives more consistent results, sperm DNA fragmentation testing can help in selected cases (repeated miscarriage or repeated IVF failure), and genetic tests such as chromosome analysis and the Y-chromosome microdeletion test explain many cases of very low or absent sperm. For men with no sperm in the ejaculate, microsurgical sperm retrieval from the testicle (Micro-TESE) finds sperm in a good proportion of cases. In 2025, researchers reported the first pregnancy using an artificial intelligence system (called STAR) that scanned a semen sample at very high speed and found a few hidden sperm in a man previously told he had none. This is still at an early stage.

Genetic carrier screening

Expanded carrier screening tests both partners for many inherited recessive diseases at once. This is especially relevant where marriage between relatives is common, and it allows couples at risk to consider options such as genetic testing of embryos.

What has changed in treatment

·       Ovulation induction: letrozole has become the first-line tablet for many women with polycystic ovary syndrome, according to the international PCOS guideline.

·       Fertility preservation: egg and embryo freezing, and in selected cases freezing of ovarian tissue, can protect the fertility of women before cancer treatment. See our article on [fertility preservation in cancer patients](/fertility-preservation-in-cancer-patients/).

·       Personalised treatment: hormone levels, ovarian reserve and the cause of infertility are used together to choose between natural trying, IUI, IVF or ICSI, instead of one plan for everyone.

·       Digital tools: ovulation apps and wearable devices help some couples time intercourse, and telemedicine allows a first consultation from home, which is valuable for couples living abroad.

Tests and treatments without proof

Alongside real progress, many tests and treatments are promoted to anxious couples without good evidence: extensive “immune” blood panels, some supplements with impressive claims, and add-ons that promise to “boost” results. The new WHO guideline and the ESHRE guidelines help separate what is useful from what is not. A good specialist recommends a test only when its result will change the treatment.

How an infertility specialist keeps up, and why it matters

The specialist’s knowledge is the patient’s first tool. Keeping it current requires a steady routine:

·       Guidelines: the WHO guideline on the prevention, diagnosis and treatment of infertility (2025), the ESHRE guidelines (for example on unexplained infertility and endometriosis), the international evidence-based PCOS guideline, the WHO laboratory manual for semen analysis, and the European Association of Urology guidelines on male infertility.

·       Journals and reviews: Human Reproduction, Fertility and Sterility, Andrology, and the Cochrane Gynaecology and Fertility reviews.

·       Congresses and online learning: ESHRE and ASRM meetings, their webinars, and specialised andrology and reproductive endocrinology courses.

·       Teamwork: regular discussion with embryologists, andrologists, urologists and geneticists, because many couples need more than one specialty.

·       Critical thinking: asking of every new test whether it has been studied properly, whether it improves the chance of a live birth, and whether it is worth the cost to the couple.

·       Self-audit: reviewing the clinic’s own outcomes and patient experience, and learning from cases that did not go well.

When a specialist does not keep up, couples pay with time, which is the one thing that cannot be recovered in fertility, especially for women over 35. They may receive treatments that have been replaced, miss a diagnosis that a modern test would have made, undergo surgery that is no longer advised, or spend money on unproven extras. Staying current is therefore not only a professional duty; it is a direct part of patient care.

Our approach

Dr. Najeeb Layyous is a member of the European Society of Human Reproduction and Embryology, the Jordanian Fertility Committee, the Jordanian Society for Fertility and Genetics and the Cochrane Menstrual Disorders and Subfertility Group. We assess both partners from the first visit, use the tests that will change the plan, and explain each option clearly so that every couple can decide with full information.