Fertility Testing for Women

Fertility Testing for Women

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At your initial fertility consultation, we will review your medical history and conduct a basic physical exam.

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To help your physician understand the quantity and quality of eggs remaining in your ovaries (i.e., “your ovarian reserve”), your care team will perform blood tests to evaluate various hormones: anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2). FSH, LH, and E2 may collectively be referred to as “Day 3” blood tests for a fertility workup, as they are drawn on the third day of a woman’s menstrual cycle. These hormones are also monitored during your treatment cycle to help guide the course of treatment.

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To evaluate your uterus and ovaries, we will perform an internal ultrasound. This test helps determine your ovarian follicle count (a marker of your ovarian reserve of eggs), as well as diagnose ovarian cysts, fibroids, polyps, or malformations. Transvaginal ultrasounds are also used to monitor your treatment cycle when taking medications that stimulate the follicles in your ovaries. During transvanginal ultrasound, a wand is inserted into the vagina and moved around gently, which may cause a feeling of pressure or very mild discomfort.

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A hysterosalpingogram (HSG) is an x-ray of the uterus following injection of dye through the cervix. This test is used to reveal any blockages in the fallopian tubes or any uterine abnormalities. During the procedure, it is common to experience menstrual-like cramps or minor short-term discomfort. Women with blocked fallopian tubes, however, may report more intense pain. An HSG is typically performed by a radiologist at an outside facility.

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A saline sonogram, also known as a saline infusion sonogram (SIS) or sonohysterogram (SHG), is a procedure conducted to evaluate the uterus and the shape of the uterine cavity. A sterile saline fluid is placed inside the uterus via a thin catheter through the cervix, while a transvaginal ultrasound is conducted, allowing your physician to visualize the uterus and endometrial cavity (uterine lining). The ovaries are also seen at the time of the SIS. A saline sonogram is used to identify any abnormalities, including uterine fibroids, polyps, cysts, or scar tissue inside the uterus.

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A preconception counseling session can be conducted even before you begin trying to conceive. Preconception counseling starts with the health and wellness of the mother. Smoking cessation, initiation of prenatal vitamins, and identifying an optimal dietary and exercise regimen are great first steps. Genetic testing can identify if the mom or couple are at risk of passing on a heritable condition to the baby. A basic preventative session will ultimately create a healthier mom and the opportunity to have a healthier pregnancy and a better reproductive outcome.