The tests performed during the infertility evaluation seek to answer the following questions:
- Is ovulation taking place?
- Are the fallopian tubes normal and open?
- Is the uterine cavity normal?
- Are your hormones within normal limits?
- Is the semen analysis within normal limits?
Once the test results are received and the above questions are answered, the doctor can then determine the best course of treatment for the patient.
Female Infertility Tests
The initial workup for female infertility may include various diagnostic tests and blood tests. These may include, but are not limited to a hysterosalpingogram (HSG), sonohystogram (SHG), and blood tests to check the levels of progesterone, estradiol, follicle stimulating hormone (FSH), and leutinizing hormone (LH). Depending on the patient's health history, the physician may recommend additional tests such as hysteroscopy, ultrasound, laparoscopy, and blood levels of prolactin, thyroid, or androgens. Treatment plans are based on the results of these tests.
Hysterosalpingogram (HSG) - The HSG is done during the first half of a woman's menstrual cycle, usually between days 7 and 10. A special dye is injected into the uterus through a small tube inserted into the cervix through the vagina. Once the dye has been injected, an X-Ray is taken. The HSG can detect if the fallopian tubes are open, thus allowing the egg to travel unobstructed to the uterus for implantation. The procedure can also help detect anatomic problems, obstructions, fibroids, and polyps.
Some cramping can occur during and after the procedure. It is common to experience a vaginal discharge for a few days following the procedure as the dye slowly seeps from the uterus. The patient may want to use a pad or liner during this time.
Be sure to let the doctor know if you have any allergies to Iodine or Betadine before the procedure.
Click here for an ASRM fact sheet on the HSG.
Sonohyterogram (SHG) - The SHG (also known as hysterosonography) is an ultrasound test in which saline is injected into the uterus through a small tube inserted into the cervix. The injected saline will slightly inflate the uterus which significantly improves the clarity of the ultrasound picture. The procedure is used to detect abnormalities of the uterine cavity such as polyps and fibroids, examine the lining of the uterus, and can also help in determining the cause of abnormal vaginal bleeding.
Note: The HSG can be better at indicating whether or not a woman's fallopian tubes are open and unobstructed, whereas an SHG can be more useful when checking for polyps & fibroids.
Click here for an ASRM fact sheet on the SHG.
The initial workup for male infertility includes a semen analysis and blood work. You might also hear this testing referred to as Andrology, which is the study of functions or disease pertaining to males--especially reproduction and infertility. Blood work will evaluate the levels of hormones such as testosterone, luteinizing hormone, and follicle-stimulating hormone.
The semen analysis is performed to determine if there are any sperm abnormalities by providing an evaluation of the sperm count, sperm motility, and structure (morphology) of the sperm.
For optimal test results, the male should abstain from sexual activity (ejaculation) for 3 days prior to the test. The male will produce the semen specimen by masturbation. Although your partner may assist, avoid oral and vaginal stimulation. Also avoid soaps, detergents, creams and lubricants to aid specimen collection, because these agents may affect the outcome of the test.
If there is any spillage, please let the embryologist know which portion (first or towards the end) was not collected. This is very important for our analysis.
Click here for an ASRM fact sheet on male infertility testing.