Diagnosis

The following tables contain the most common diagnostic procedures of your comprehensive evaluation to determine the underlying cause of your infertility.

Preliminary Screening Test

For most couples, several tests will be required prior to initiating the IVF cycle. These are designed to look for problems that could have an adverse impact on your treatment or subsequent pregnancy. If you have had any of the tests listed below done, please make the results available to your Nurse. Depending upon the test, you may not need to have the test repeated immediately prior to your cycle. Because of the nature of some tests, we will ask that certain tests be done at RMATX or by a lab approved by our office.

Female Testing

Blood Tests

• FSH / Estradiol - This combination of FSH (follicle stimulating hormone) and estradiol drawn on day 2, 3 or 4 of the cycle is a reflection of the female partner’s ovarian reserve, or how well we expect her ovaries to respond to stimulation. We will generally test all women regardless of age because of the wide range of variation of the onset of menopause and ovarian dysfunction in infertility patients. These tests will help us determine which procedures and protocols are most appropriate.
• Infectious Screen (hepatitis, syphilis, HIV) - Having one of these infections could adversely affect the outcome of your procedure or your pregnancy should you become pregnant.  The labs are preformed for patients undergoing IVF or using some form of third party reproduction (donor egg/sperm or gestational carrier).
• Pregnancy Screen: (Blood type and Rh Factor, Rubella titer,complete blood count) - Determining Blood type can be helpful if there are problems with a pregnancy. Rubella is an infection that can cause serious birth defects if it occurs while you are pregnant. Most of us have been immunized against it. However, some people have not been immunized or their immunization is no longer working. This test determines if immunization is needed. A complete blood count screens for anemia and other blood disorders and can tip us off about certain inherited disorders.
• Prolactin, TSH – These hormonal tests screen for subtle abnormalities that could effect your treatment or your pregnancy. Both hormones are made by the pituitary gland in the brain. Prolactin is a hormone that helps to stimulate milk production during breast-feeding. Some women will secrete too much prolactin when not breast-feeding.TSH (thyroid-stimulating hormone) is the most sensitive test of thyroid function. It can detect either over-activity or under-activity of the thyroid gland.The thyroid is very important for a healthy pregnancy.
• Other testing – If your medical history, family history or testing suggests that you may be at risk for genetic or autoimmune diseases, or other medical problems, appropriate tests will be ordered prior to initiating the cycle.

Radiologic Evaluation

• A hysterosalpingogram(HSG) or sonohysterography (saline sonography) - Will be done to evaluate the inside of the uterine cavity. The HSG can also evaluate the fallopian tubes.
• Baseline Ultrasound – This is done at the initial visit. It allows us to look at the muscle of the uterus as well as assess the ovaries.
• Mammogram – A screening test for breast cancer. Mammograms should be performed yearly starting at age 40. Some high-risk women should have earlier screening.

Trial Transfer

A special catheter is inserted into your uterus to determine the direction and length of the uterine cavity. This measurement may also be done in concert with a saline ultrasound. This is done so that when the actual embryo transfer is done, it will occur in the smoothest possible fashion.

Pap smear

A screen for cervical cancer and human papilloma virus infections. Currently, screening for most women is to be done on a yearly basis.This is to be performed by your Ob/Gyn.

NOTE: Some women may require more frequent mammogram and Pap smear testing, depending on their medical and family histories.

Male Testing

Semen Analysis and Cryopreservation

A Semen Analysis is required to determine if the male partner’s sperm is normal. If the sperm is compromised, ICSI may be necessary (intracytoplasmic sperm injection) to optimize fertilization. Cryopreservation is a process whereby sperm is frozen to be used if there are any issues with producing a fresh specimen during your IVF cycle or if the male partner is not geographically close to the clinic.

Infectious Screening: (HIV, Syphilis, Hepatitis B and Hepatitis C, HTLV)

These labs are performed if crypreservation is desired, IVF is to be used, or any form of third party reproduction.

Special Male Testing

Men with certain infertility problems may be asked to get any of the following tests.

• Karotype - This is a test that evaluates the chromosomes. In some conditions, the rate of chromosomal abnormalities is increased. If a genetic abnormality is detected, genetic couseling and therapies like PGD and donor sperm are available.
• Y-deletion testing – In some men with very low sperm counts, the problem is due to structural abnormalities in the segment of the Y-chromosome that impacts sperm development. Pregnancy can occur (via IVF with ICSI), but these abnormalities can be passed on to any male children.
• Cystic Fibrosis – Cystic fibrosis is a genetic disorder, which is characterized by excessively thick secretions form mucus glands. It is the most common lethal genetic disease in the Caucasian population. About 1 in 25 Caucasians carry the gene. However, in certain disorders that are associated with male infertility, the chances of carrying the abnormal gene are 1 in 4. If it were found that you carry the gene, then your wife would be tested.