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The Female Infertility Testing
1. Hormonal studies – These tests help identify any hormonal imbalance that may impair infertility. There are different hormones in the body that play a role in conception, it is important for your body to produce a specific amount at a precise time during your menstrual cycle for conception to occur naturally.
2. Ovarian reserve – The term “ovarian reserve” refers to a woman's remaining egg supply that can produce babies. A woman's fertility depends on the quality and quantity of eggs in her ovaries, as well as how well the ovarian follicles are responding to hormonal signals from the brain. There ovarian reserve blood test are specifically AMH and FSH + E2. These hormone levels can give us a better sense of our fertility timeline, egg freezing and In Vitro Fertilization (IVF) outcomes, future red flags, and menopause onset, than just age.
3. Ultrasound – An infertility Pelvic US with antral follicular count (AFC) is used to verify that the uterus and both ovaries are present. The shape, size, and the position of the uterus is recorded. Any masses with the uterus such as fibroids are measures and mapped. The size of the ovaries and the number of growing follicles is recorded. A common abnormal finding on an infertility ultrasound is ovarian cysts. Most often, ovarian cysts are simply evidence of a growing egg or evidence of recent ovulation. On occasion, however, a cyst may represent an abnormality such as endometriosis.
4. Hysterosalpingogram (HSG) – It is an x-ray examination of a woman's uterus and fallopian tubes that uses a special form of x-ray called fluoroscopy and a contrast material. The HSG test is used to verify that the Fallopian tubes are open and visualize the inside of the uterus. HSG is done in a hospital, clinic, or health care provider’s office. It is best to have HSG done in the first half (days 1–14) of the menstrual cycle. This timing reduces the chance that you may be pregnant.
5. Sonohysterography (SIS) - is a special kind of ultrasound exam. Normal saline is put into the uterus through the cervix using a thin plastic tube. Sound waves are then used to create images of the lining of the uterus. The fluid helps show more detail than when ultrasound is used alone. SIS can find the underlying cause of many problems such as abnormal uterine bleeding, infertility, and repeated miscarriage. It is able to detect the following:
• Abnormal growths inside the uterus, such as fibroids or polyps, and information about their size and depth
• Scar tissue inside the uterus
• Abnormal uterine shape
• Problems with the lining of the uterus
• Whether the fallopian tubes are open or blocked
It is best to have HSG done in the first half (days 1–14) of the menstrual cycle. This timing reduces the chance that you may be pregnant.
6. Genetic Screening - Genetic screening is the application of a test on people for the systematic early detection or exclusion of a hereditary disease, a genetic predisposition to a disease, or to determine whether a person carries a predisposition which may produce a hereditary disease in their offspring.
Male Infertility Testing
According to the statistics, in 40-50 percent of infertility cases, a male factor is the cause. It is necessary and important to complete a semen analysis as part of the initial work up in addition to the female diagnostic work up.
1. The semen analysis, or sperm count test, analyzes the health and viability of a man’s sperm. Semen is the fluid that is released during ejaculation. As semen analysis measures four major factors of the sperm health:
• the volume of the semen
• the number (concentration) of the sperm
• the movement (motility) of the sperm
• the shape and size (morphology) of the sperm
• Other factors include the pH, progression of the sperm, the absence of present of white, red, or immature sperm, viscosity.
An abnormal initial semen analysis may indicate a repeat test in some case.
2. Hormone studies may be indicated in some cases. For example, if there is persistent abnormal semen analysis, the provider may want to check for hormone imbalance. The test will include:
Follicle-stimulating hormone (FSH): a male and female hormone; in males, FSH helps maintain sperm production.
Luteinizing hormone (LH): a male and female hormone; in males, LH stimulates the production of testosterone.
Prolactin: Higher levels of prolactin can be indicative of a pituitary problem and can affect overall total testosterone levels.
Thyroid-stimulating hormone: a male and female hormone; in males TSH can affect the quality semen, low sperm count, reduced testicular function, erectile dysfunction, and a decrease in the libido (sex drive).