Fertility Tests
Fertility tests are medical examinations and procedures used to evaluate the ability of an individual or couple to conceive and carry a pregnancy to term. These tests can assess various aspects of reproductive health, including hormone levels, ovulation, sperm quality, and the condition of the reproductive organs.
Hormone Evaluation
Hormone Testing
Levels of FSH, LH, and estrogen will be measured on day three of the menstrual cycle. High FSH levels are usually an indication of decreased egg quality. Anti-mullerian hormone levels, which also assess ovarian reserve, are often measured. The Clomid Challenge Fertility Test may also be administered to further assess ovarian reserve. Androgen levels will be measured to rule out conditions such as PCOS. Thyroid hormones will be assayed to rule our” hyper” or “hypo” thyroidism.
Ovulation
Hormone Testing
Ovulation must occur regularly each month. Ovulation can be monitored/predicted by creating a basal body temperature chart (BBT). The more accurate urinary LH test kit is used most often. Progesterone levels rise after successful ovulation. Follicular development and release can also be monitored via transvaginal ultrasound.
Document Proper Development of The Endometrium
The lining of the uterus (endometrium) must thicken and become more vascular during the monthly ovulatory cycle. This is critical for successful embryo implantation and support. Estrogen and progesterone provide hormonal support for endometrial development. The width of the endometrium can be measure using ultrasound and an endometrial biopsy may be performed.
HSG
Hysterosalpingogram, HSG
The HSG fertility test provides information about the internal architecture of the fallopian tubes and the uterus.. Dye is passed through a small tube through the cervix and into the uterus. The dye is “radiopaque” meaning that it can be visualized on X-ray.
USG
Vaginal probe ultrasound is used extensively to monitor follicles during ovulation induction cycles for IVF and often for stimulated IUI. Another use is to measure the thickness of the endometrium to confirm that it is developing properly. Ultrasound is also used to document pregnancy, by visualizing the fetus, as well as detecting early fetal heart motion.
Semen Analysis
Semen Analysis, An Essential Fertility Test
The semen analysis is one of the most important fertility tests given that up to half of all infertile couples with have a male infertility component. Given the extreme importance of ruling out subtle male infertility, it is best to have the analysis done at a reproductive medicine laboratory. These laboratories hire laboratory directors and technicians who are specialists in the evaluation of sperm. These specialists usually have years of clinical experience in identifying all types of semen abnormalities.
Others
Hysteroscopy
The hysteroscope is a small tubular “telescope” like device that is inserted through the vagina and into the uterus. The uterus is filled with carbon dioxide or another media such as sterile saline causing it to expand. The physician can often clearly visualize conditions such as fibroids, polyps, or congenital uterine abnormalities using hysteroscopy. If hysteroscopy is performed in an operating room, treatment can usually be performed at the same time (operative hysteroscopy).
3D Saline Sonogram
In the saline sonogram (also know as a hysterosonogram or sonohysterogram) the uterus is filled and expanded with saline (salt solution) using a catheter passed through the vagina and cervix into the uterus. Ideally 3D (three dimensional) ultrasound vaginal probe is then inserted into the vagina and abnormalities such as fibroids and polyps can usually be seen.
Endometrial Biopsy
The endometrial biopsy may be considered in certain circumstances such as for performing the E-tegrity test to evaluate the endometrium for the presence of certain substances (beta 3 integrins) that are felt to be necessary for implantation. It can also be used to evaluate the patient for chronic endometritis (endometrial infection) or endometrial hyperplasia (thought to be a precursor to endometrial cancer). Endometrial hyperplasia is more common in women with PCOS who have not used fertility drugs to induce regular cycles.
Post Coital Test
The post coital fertility test (PCT) allows for evaluation of sperm in the cervical mucus and to determine the consistency of the mucus.
Genetic Testing for Inherited Diseases
Genetics is one of the fastest growing and most exciting areas of modern medicine. A few years ago, the amazing project of mapping the entire human genome was complete.