Fertility Workup
Fertility Workup

Fertility Testing & Diagnosis

Fertility testing helps to provide you and your physician with a picture of your current fertility level and helps gauge how your body will likely respond to fertility medications. This is an essential part of establishing a treatment plan for patients actively trying to conceive and for individuals and couples looking to plan for pregnancy in the future.

Fertility diagnostics help your physician determine what may be preventing conception, such as issues with ovulation, blocked fallopian tubes, uterine abnormalities, or sperm quality or quantity. Diagnostic tests for female patients assess hormone levels, egg quantity and quality, and reproductive anatomy. The male patient will typically undergo a semen analysis and may require additional testing as well.

For Women

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For Men

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Diagnostic Testing for Female Fertility

History and Physical Exam

During your initial consultation, a complete medical history will be taken and a basic physical exam will be performed.

Hormone Blood Tests

Your doctor will request a set of blood tests in order to evaluate hormone levels, specifically, anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2). FSH, LH, and E2 are known as “Day 3 blood tests” and are tested on the third day of your menstrual cycle. The results of these tests provide important information about your ovarian reserve as well as the quantity and quality of your eggs. These three hormones are also monitored closely during a fertility treatment cycle, such as IVF.

Transvaginal Ultrasound

Your doctor will use a transvaginal ultrasound probe to observe and assess the health of your uterus and ovaries. During the procedure, the ultrasound wand is inserted into the vagina and gently moved around. Patients may feel pressure and/or mild discomfort. Your doctor will take an Antral Follicle Count (AFC), which measures the quantity of egg follicles present in the ovaries. This helps determine your current ovarian reserve. The ultrasound also helps identify the presence of any ovarian cysts or uterine pathologies, such as polyps, fibroids, or other abnormalities. Additional imaging may be needed depending on the results of the ultrasound and the type of treatment sought.

Hysterosalpingogram (HSG)

Your doctor may request that a hysterosalpingogram (HSG) be performed to help determine whether you have any uterine abnormalities or blockages in the fallopian tubes. During an HSG, a radiology specialist injects a special dye into the uterine cavity and takes x-ray images of your reproductive organs. You may experience minimal period-like cramping or discomfort during or directly after the procedure. If there is a blockage in the fallopian tubes, you may temporarily experience more severe discomfort.

Saline Sonogram

Saline Infusion Sonogram, also known as a Sonohysterogram, is a procedure performed in the office in order to evaluate the inside of the uterus and check for abnormalities, such as fibroids, polyps, or scar tissue. During the procedure, a saline solution is placed inside of the uterus during a transvaginal ultrasound. The saline fills the uterine cavity so it can be better visualized on ultrasound.

Preconception Counseling

Prior to starting treatment, your doctor may recommend preconception counseling. This is advised to help enhance the health and wellness of female patients in particular, as they will be carrying the baby. During preconception counseling, you will be asked to stop tobacco use, begin taking prenatal vitamins, and initiate a healthy diet and exercise routine (if not already underway). Additionally, genetic testing may also be performed in order to determine if there is a risk of passing on inheritable conditions to the baby.

Endometrial Biopsy

Your doctor may order an endometrial biopsy if you experience recurrent implantation failure (RIF) and are unable to achieve pregnancy after repeated embryo transfers. The procedure involves removing a small amount of tissue from the uterine lining right before a patient’s menstrual cycle begins. The tissue is evaluated for abnormalities and aids the physician in forming a diagnosis.

Post-coital Test

To evaluate sperm and cervical mucus, a post-coital test is performed two to eight hours after intercourse. The test involves removing a sample of mucus from the cervical opening using a needleless syringe. The sample is then closely observed using a microscope to see if there are any motile sperm present. Prior to the test, couples must abstain from intercourse for at least two days before ovulation.

Basal Body Temperature Charting

When at complete rest, your body is at its basal body temperature. During ovulation, this temperature is slightly higher, which can make it easier to determine when ovulation is taking place. To properly chart your basal body temperature, you will need to use a thermometer to take your temperature every morning when you first wake up and record the results in a notebook, diary, calendar, or your phone. If your temperature increases by 0.5 degrees, it’s a sign that you are ovulating.

Diagnostic Testing for Male Fertility

Semen Analysis

The first step in male fertility testing is to complete a semen analysis. This test evaluates your sperm count, sperm motility and shape, and volume of ejaculate.

Medical History and Physical Exam

Our urologist will complete a full medical history and physical exam during the initial consultation. It will be important to fully disclose lifestyle details, medication(s), and whether any known genetic factors are of concern.

Hormone Blood Tests

Your doctor may order blood tests to screen for different hormone levels, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone total, and estradiol (E2). Testing for testosterone level is especially important; not only can low testosterone indicate reduced or inhibited sperm production, but it can also be a sign of other health concerns.

Choosing RMA of New York at CareMount for Fertility Testing

Since 2001, RMA of New York has successfully facilitated the births of thousands of healthy babies for patients across the New York City metro area and beyond. By combining RMA of New York’s world-renowned expertise in reproductive care with CareMount’s long-standing commitment to delivering local exceptional care, we’re able to offer that same personalized, state-of-the-art fertility care right in your Hudson Valley neighborhood. We provide the expertise, technology, research, resources, and compassion needed to help ensure your future family is in the best of hands. No matter the path needed to complete your family-building goals, you can count on our team to be in your corner every step of the way.

To learn more about fertility testing with RMA of New York at CareMount, please:

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