Infertility testing or work-up is performed by either your OBGYN, Urologists and or fertility specialists. At RMA we can usually complete an infertility work-up in 30-days or less. Certain hormones such as follicle-stimulating hormone (FSH), anti-mullerian hormone (AMH), and estrogen (estradiol E2) can provide important clues about female fertility especially egg quality and quality. For men, a semen analysis can provide a critical understanding of sperm motility or morphology.
Ovarian function is assessed through blood tests and a transvaginal ultrasound. AMH, day 3 FSH, and estrogen levels assess egg reserve. Through transvaginal ultrasound, your physician will assess your follicle count (another marker of egg reserve) and look for any abnormalities on the ovaries. If you have irregular menses, your doctor can check your thyroid function (TSH), prolactin, 17- hydroxyprogesterone (17-OHP), androgens, and markers of insulin resistance.
Your uterus may be evaluated with a transvaginal ultrasound, a hysterosalpingogram (HSG), and / or a saline sonogram. Transvaginal ultrasound provides information on the shape of the uterus and detects some uterine abnormalities, including fibroids. A hysterosalpingogram is used mainly to determine if your fallopian tubes are open or blocked. A saline sonogram can provide more information about the interior of your uterine cavity, identifying problems such as scar tissue, polyps, or problematic fibroids.
Sperm will be assessed through semen analysis and anti-sperm antibody testing. Partners collect their sample in the office, though a specialized collection container is required in either case. Ejaculate volume, sperm concentration, sperm motility, and sperm shape are assessed. For patients using donor sperm, we are happy to help you identify sperm banks and coordinate shipping from the sperm to RMA for your use.Learn More About Male Infertility
Genetic screening is an important component of your initial evaluation. All patients are at risk of having a child affected by a genetic disorder. Fortunately, modern fertility treatment techniques can reduce a couple’s risk of having an affected child. While genetic screening tests cannot prevent all birth defects, they are a key risk-reducing measure for couples contemplating pregnancy.
Additional lab work will be completed to screen for general health concerns and sexually transmitted diseases. If you have a preexisting health problem, such as diabetes or hypertension, your physician will order specific blood tests and may require you to obtain clearance for pregnancy from outside physicians monitoring your disease.