In order to determine if you may still be able to become pregnant with or without assisted reproductive technology (ART), we conduct thorough Infertility Testing for our patients. Before a course of treatment can be recommended, the cause of infertility must be pinpointed as precisely as possible. CFC offers a full range of infertility testing services covering the following key areas that may affect a couple’s fertility:
- Uterine health
- Ovarian and fallopian tube health
- Semen analysis
- Overall endocrine/hormone health
- Overall health
As a critical first step, you and your partner will provide your own medical history. Then a directed physical examination is conducted along with blood tests.
Men are encouraged to test their semen through a semen analysis (aka sperm andrology), which examines the seminal fluid itself, along with the sperm in it. The average sample contains 255 million spermatozoa, with 39 million being the low reference, according to the World Health Organization. Testing for motility is also important in order to judge how many of the sperm are active, and are graded A (for progressive motility) through D (for total immotility). The morphology of the sperm is tested to ensure the sperm are properly formed. Even the pH balance of the sperm—7.2-7.8— is taken into account.
For a healthy woman, her immature eggs develop in her ovaries until they are mature enough to be released (ovulation) into the fallopian tubes usually every 28 days. This reproductive system is controlled through hormone signals released from the brain (endocrine system). Fertilization usually occurs in the fallopian tubes when a sperm reaches and penetrates the mature egg. This fertilized egg (embryo) then travels to the uterus where it attaches (implants) onto the uterine wall to achieve pregnancy. The embryo then eventually grows to become a baby in the uterus. Therefore, it is critical for women struggling with infertility to take initial tests to check her ovaries, fallopian tubes and uterus.
An ovarian reserve test is performed to predict egg quality, egg quantity and reproductive potential. The most popular ovarian reserve tests evaluate the woman’s levels of follicle stimulating hormone (FSH), estradiol, and Anti-Müllerian hormone (AMH). Women with elevated levels of FSH and/or estradiol may have reduced pregnancy rates with IVF or may need more medications during IVF. AMH levels generally reflect the remaining number of eggs. Ovarian reserve testing is especially important for women who have a higher risk of reduced ovarian reserve such as women who:
- are over age 35 years;
- have a family history of early menopause;
- have a single ovary;
- have a history of previous ovarian surgery, chemotherapy, or pelvic radiation therapy;
- have unexplained infertility; or
- have shown poor response to gonadotropin ovarian stimulation.
Depending on your situation, we may conduct one or a combination of the following tests to further check your reproductive organs:
- Pelvic/Transvaginal Ultrasonography: An ultrasound probe is placed in the vagina, allowing the doctor to check the uterus and ovaries for abnormalities such as fibroids and ovarian cysts. The ultrasound also allows the specialist to determine the number and size of the woman’s ovarian follicles, the structures where a woman’s eggs (oocytes/ova) develop to maturity.
- Hysterosalpingogram (HSG): This X-ray procedure shows if the fallopian tubes are open and if the shape of the uterine cavity is normal. A catheter is inserted into the opening of the cervix through the vagina to inject a liquid containing iodine contrast. The contrast fills the uterus and enters the fallopian tubes, outlining the length of the tubes, and spills out their ends if they are open.
- Sonohysterography: This procedure uses transvaginal ultrasound after filling the uterus with saline (a salt solution). This improves detection of intrauterine problems such as endometrial polyps and fibroids compared with using transvaginal ultrasonography alone. If an abnormality is seen, a hysteroscopy is typically done.
- Hysteroscopy: This is a surgical procedure in which a lighted telescope-like instrument (hysteroscope) is passed through the cervix to view the inside of the uterus. Hysteroscopy can help diagnose and treat abnormalities inside the uterine cavity such as polyps, fibroids, and adhesions (scar tissue).
Based on the findings of your tests, CHA Fertility Center can streamline a treatment protocol specifically to your needs. Abnormalities such as polyps, fibroids and endometriosis must be carefully monitored and dealt with as they can interfere with pregnancy and/or gestation, which can lead to miscarriage. Depending on size and location of these abnormalities, the doctor may recommend medication, surgery or other forms of treatments and family planning to help you achieve your family goals.
Fertility Treatments & Services
In-Vitro Fertilization (IVF)
Intrauterine Insemination (IUI):Artificial Insemination
Blastocyst Transfer with IVF
Intracytoplasmic Sperm Injection (ICSI) with IVF
Assisted Hatching (AH) with IVF
Genetic Testing and Diagnosis:Pre-Implantation Genetic Diagnosis (PGD) and Pre-Implantation Genetic Screening (PGS)
Family Balancing – Sex/Gender Selection
Embryo Freezing (Cryopreservation)
Egg/Sperm Donor Program:3rd Party Reproductive Services
Gestational Surrogacy:3rd Party Reproductive Services
Minimal Stimulation IVF (Mini IVF)