Fertility Testing

For Women

The professionals at Aurora believe the decision to undergo fertility testing and treatment is an important one and should be considered in terms of your age, how long you have been having unprotected intercourse, and other factors.

The guidelines we follow to determine if you should undergo fertility testing are below. These are the same guidelines we provide to physicians who refer our patients to us:

• Under 35 years of age after 12 months of unprotected intercourse;
• Aged 35-39 after 6-12 months of unprotected intercourse;
• 40 years of age or older after no more than 6 months of unprotected intercourse;

In addition, if you have irregular or absent menstrual cycles, known or suspected problems with your reproductive system (uterus, tubes, endometriosis, etc.), or if your partner has known or suspected fertility issues, fertility testing should be conducted.

While we don’t ask that specific testing is necessary prior to referring a patient to our clinic, we do ask that your physician work with you in advance of a referral to get healthy for pregnancy. This means ensuring you are at a healthy weight, are following a healthy diet and exercising, not smoking, and taking prenatal vitamins.

Testing for Female Infertility

Once you have been referred to our clinic, we will meet with you to discuss fertility testing options. We evaluate our patients based on their own individual circumstances, and believe the least invasive tests should always be done first.

The information below provides a brief summary of some of the tests we may suggest for you. As always, we’re here to answer any additional questions you may have about fertility testing.

Blood Tests – When testing your blood, we’ll be looking at a number of things. Thyroid-stimulating hormone (TSH) and prolactin levels are useful to identify thyroid disorders and hyperprolactinemia, which may cause problems with fertility, menstrual irregularities, and repeated miscarriages. In women who have hirsutism (hair on the face and/or down the middle of the chest or abdomen), we will test for dehydroepiandrosterone sulfate (DHEAS), 17-α hydroxyprogesterone, and testosterone. A blood progesterone level test done after ovulation can help us determine whether or not you are ovulating. We may also recommend a screening test for diabetes if you have risk factors for this such as polycystic ovary syndrome (PCOS), obesity or a family history of diabetes.

Ovarian Reserve Testing - Ovarian reserve testing will help us predict your ability to produce an egg, or good quality eggs, and tell us how well your ovaries respond to hormonal signals from your brain. It can also help to predict whether your ovaries have enough eggs left to respond to fertility treatments. The most common test to evaluate ovarian reserve is a blood test for follicle stimulating hormone (FSH) and estradiol on day 3 of your menstrual cycle. We may also recommend other blood tests such as antimüllerian hormone (AMH). A transvaginal ultrasound can help us determine the number of follicles or egg sacs present, also called an antral follicle count (AFC).

Sonohysterography - A sonohysterogram, or “sono,” is done at the clinic. A small tube, or catheter, is placed into the cervix through the vagina. After filling the uterus with a saline (salt solution) through the catheter, this procedure uses transvaginal ultrasound to help detect problems such as endometrial polyps and fibroids and can determine if the tubes are open. This test takes approximately 10-15 minutes. We recommend taking 2 ibuprofen regular strength tablets 1-2 hours prior to this test as cramping may occur. If an abnormality is seen, a hysteroscopy (see below), may be recommended.

Hysterosalpingogram (HSG) - An HSG may be recommended as an alternative to a sonohysterogram, especially if you are at risk for tubal disease. An HSG is done in the X-ray department at the hospital. This procedure will help us see if the fallopian tubes are open and if the shape of the uterine cavity is normal. A small instrument is inserted into the opening of the cervix through the vagina. A liquid which contains iodine is injected through the catheter into the uterus and tubes and X-rays are taken to help us see the length of the tubes, and determine if there could be a blockage. This test takes approximately 10-15 minutes. We recommend taking 2 ibuprofen regular strength tablets 1-2 hours prior to this test as cramping may occur.

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. It can help us diagnose and treat abnormalities inside the uterine cavity such as polyps, fibroids, and adhesions (scar tissue).

Laparoscopy - In this surgical procedure a lighted telescope-like instrument (laparoscope) is inserted through the wall of the abdomen into the pelvic cavity. It helps to evaluate the pelvic cavity for endometriosis, pelvic adhesions, and other abnormalities.

Our lab also requires that testing for infectious diseases such as HIV, Hepatitis B and C, syphilis, chlamydia and gonorrhea be conducted. Testing is conducted via blood and urine tests. We may also recommend genetic testing in certain circumstances.

For Men

Almost half of the time, a couple’s inability to become pregnant is due to male-related fertility issues. A low sperm count and poor quality sperm play a large role in whether or not a female’s egg can be fertilized.

Testing for male fertility begins with a medical history. Following that a semen analysis will be completed. Semen is normally collected at our facility in a private room by masturbation. The test provides information about the number of sperm present, its movement, and its shape. If the results are abnormal, more advanced testing may be recommended. It’s important to note that illness or medications taken three months prior to the analysis may temporarily affect sperm.

As hormones control sperm production, too much or too little of them can cause problems with sperm production. Blood tests may be conducted to determine the levels of follicle-stimulating hormone (FSH), luteinizing hormone(LH) and testosterone (T), important hormones for reproduction. Other hormones, such as prolactin, may also be tested to help evaluate male fertility issues.

Our lab also requires that testing for infectious diseases such as HIV, Hepatitis B and C, syphilis, chlamydia and gonorrhea be conducted. Testing is conducted via blood and urine tests. We may also recommend genetic testing in certain circumstances.