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The Infertility Evaluation

Fertility tests evaluate the separate processes that must occur for pregnancy to result. HRC infertility specialists will oversee a thorough screening of each couple's medical history and hormonal health as well as a physical exam to determine the likely cause of infertility and to create a treatment plan. 

The most common causes of infertility in the female include ovarian disease, tubal disease, endometriosis, uterine disease, cervical disease, immune disorders and a category known as unexplained infertility. "Unexplained infertility" means that a specific cause of a couple's infertility cannot be identified.

Fertility tests will be ordered to assess ovarian function including the day 3 hormone evaluation (FSH, LH, E2 and others). Elevated levels of FSH on day 3 may indicate diminishing ovarian reserve and infertility. Ovulation may also be assessed using urinary test kits, progesterone hormone measurements, ultrasound visualization and other means.

Fertility tests are also used to access the tubes and uterus. The tubes must be open and free of obstruction for the eggs to travel from the ovaries to the uterus. Fertility tests are used to evaluate the condition of the uterus and include the hysteroscope, hysterosalpingogram, ultrasound and others. The uterus must be regularly shaped and free of obstructions such as fibroids and/or polyps. The laparoscopy is a very valuable fertility test that allows the specialist to directly visualize the reproductive organs. In many cases, conditions such as endometriosis are treated during the diagnostic laparoscopy.

Fertility tests, such as the post coital test, assess the characteristics of the cervical mucus. The cervical mucus supports the transport and nourishment of sperm and must be free of antisperm antibodies and be of the correct consistency.

It is important to remember that no fertility therapy, including Clomid, should be administered to the female until the semen analysis has been evaluated. Approximately 47 percent of all infertile couples will have a male infertility component.

Clomid Challenge Test

The Clomid challenge test (CCCT) is a sensitive means to measure ovarian reserve and is often conducted if a woman's FSH level is 10-15 mIU/mL or the estradiol level is greater than 65 pg/mL The Clomid Challenge Test is routinely performed at HRC in women aged 38 years or older regardless of how the cycle day 3 levels look. This will identify patients with ovarian dysfunction.The Clomid challenge test should also be considered in women of any... Read more

Endometrial Biopsy

The endometrial biopsy involves scraping and examining a sample of tissue from the lining of the uterus (endometrium). The procedure makes it possible for the physician to determine if ovulation has occurred, and whether the lining of the uterus has undergone the changes necessary for the implantation of a fertilized egg and the support of an early pregnancy. An endometrial biopsy can also detect an infection or inflammation of the endometrium... Read more

Hysteroscopy

The hysteroscopy is an important tool in the study of infertility, recurrent miscarriage, or abnormal uterine bleeding. Diagnostic hysteroscopy is used to examine the inside of the uterus, also known as the uterine cavity, and is helpful in diagnosing abnormal uterine conditions such as internal fibroids, scarring, polyps, and congenital malformations. A hysterosalpingogram (an x-ray of the uterus and fallopian tubes) or an endometrial biopsy... Read more

Laparoscopy

Laparoscopy is a common outpatient surgical procedure that allows the physician to view reproductive organs such as the fallopian tubes, ovary, and uterus, and diagnose conditions causing infertility including endometriosis and tubal blockage. Procedure The laparoscope is a small "telescope like" instrument that is placed through a small incision in the stomach, usually at the belly button. Small operative tools are inserted... Read more

Post Coital Test

The post coital (after intercourse) infertility test is sometimes used to evaluate how sperm interacts with the cervical mucus. The couple has normal intercourse, using no lubricants, and the female comes to HRC within 24 hours. A sample of her cervical mucus is examined under the microscope.Normal, motile sperm should be seen in the sample. If numerous, inactive or "dead" sperm are seen, it could indicate an antigen antibody reaction.... Read more

Ultrasound

Ultrasound measurements have many applications in the infertility evaluation and are also used for monitoring during in vitro fertilization (IVF) cycles. The transvaginal ultrasound (through the vagina) is used frequently because it allows the physician to view the ovaries, uterus, and many other internal organs.The ultrasound produces images similar to an x-ray; however, sound waves are used instead of radiation. Many times dense... Read more

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HRC Fertility offers free seminars for new and potential patients! All seminars are conducted by one of our 10 doctors. Reservations are required and seating is limited.

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