Initial Testing Phase of Treatment

Helping determine the diagnosis and develop an appropriate treatment plan

Often times the most frustrating part of infertility is to answer the question of "Why?". To hopefully help find the answer to this question, we will have both partners complete some testing. This testing will help answer some very important questions in order to provide you with the best course of treatment. Below are some of the questions we will seek to answer through testing. Depending on your situation, additional testing may be necessary.

Are you ovulating?

We confirm this by looking at ultrasound and by conducting some hormone testing at certain times throughout your cycle.

Are your fallopian tubes normal?

This test is called a Hysterosalpingogram (HSG). "Hystero" referrers to the uterus and "salping" refers to fallopian tubes. This is an x-ray using a radio opaque dye, which is injected through a catheter in the cervix and into the uterine cavity and travels through the tubes. Pictures can then be taken for evaluation. This test evaluates both fallopian tubes and uterus.

Is your uterine cavity normal?

When only the uterine cavity needs evaluating and the fallopian tubes do not we can do a Hysterosonogram. This is an ultrasound of the uterus. Sterile water is placed in the uterine cavity through a catheter in the cervix and the cavity is evaluated for adhesions, fibroids and polyps.

Do your ovaries show signs of Diminished Ovarian Reserve?

We assess this by doing a vaginal ultrasound preferably between days 2 and 4 of the cycle. The ultrasound is done to evaluate the ovarian volume and basal antral follicles. At this time we will also evaluate the following hormone levels: E2, FSH, LH, Prolactin, Thyroid Stimulating Hormone. One of the most crucial hormone levels is the FSH.

Are your hormones within normal limits?

Once these tests are completed by your physician, we will evaluate the levels and use this information to help conclude a diagnosis and order an appropriate treatment plan.

Is the semen analysis within normal limits?

Specimens should be collected between days 2 – 5 days of abstinence. The three main parameters that are assessed are count, motility and morphology of the sample. The count should be above 20 million/ml, motility should be 50% or greater and morphology (shape of the sperm) should be at least 30% normal.