Hormonal / Endocrine Testing
Small changes / abnormalities in certain hormones can affect ovulation, as well as oocyte quality and function. Testing is also sometimes recommended in males who have suboptimal sperm function.
Ovarian Reserve Testing
‘Ovarian reserve’ refers to the egg supply that a woman has remaining, and decreases with age. Common tests used to help predict ovarian reserve are Anti-mullerian Hormone (AMH), Follicle Stimulating Hormone (FSH), and Estradiol, as well as Antral Follicle Count via ultrasound.
Serum Androgen Levels
Androgens are required by both males and females for reproduction. However, too much androgen in a female or too little androgen in a male can both adversely affect fertility.
Semen Analysis
Sperm parameters tested include volume and thickness of semen, concentration of sperm, sperm count, sperm’s ability to move (motility), sperm structure (morphology), and number of immature sperm and inflammatory cells in the semen.
Ovulation Testing
While serum luteal progesterone is the most reliable test to confirm that ovulation has occurred, several other tests can be used to predict when ovulation will take place including urine or serum luteinizing hormone (LH), mid-cycle progesterone levels, and ultrasound visualization.
Genetic Carrier Screening
Carrier screening is an optional test that can tell you if you carry a gene for certain genetic disorders. All women are offered this screening for certain disorders such as cystic fibrosis, hemoglobinopathies, and spinal muscular atrophy (SMA), and more extensive screening is also available that tests for over 200 other disorders.
Sperm DNA Fragmentation Testing
DNA in sperm can become fragmented by a variety of factors, including varicoceles, infection, aging, and several lifestyle factors. This is a test that may be performed in the event of unexplained infertility, recurrent pregnancy loss, or if a male is at high risk for DNA fragmentation.
Parental Karyotypes
These detect whether a parent carries an aneuploidy or translocation. Since most aneuploidies and translocations manifest in symptoms, the most common finding in an asymptomatic adult is an unbalanced translocation.
Array-CGH
Typically performed on products of a miscarriage to determine whether an aneuploidy or unbalanced translocation might exist so that such abnormalities can be avoided in future pregnancies.
Endometrial Receptivity Testing
This test predicts the optimal window of time in the ovulatory cycle for an embryo to attach and implant in the uterus. It is an optional test that may be recommended by our team to optimize success of your embryo transfer.
Transvaginal Ultrasound
In order to best visualize what is happening in your pelvic cavity a thin ultrasound probe is inserted into the vagina, giving us the most optimal view of your uterus, fallopian tubes, ovaries, and surrounding structures. 3-D images will sometimes be obtained to optimally diagnose some uterine abnormalities.
SonoHSG
SonoHSG/SIS
While performing a transvaginal ultrasound the uterus is distended with saline, allowing the most optimal view of the endometrial cavity and fallopian tubes (saline-infusion ultrasound). Air can then be injected into the tubes to determine if they are open (sonoHSG or HyCoSy).
HSG
The uterus is distended with contrast solution while an x-ray of the pelvis is being performed. This is the best non-invasive test to confirm tubal occlusion, but is sometimes unnecessary if tubal patency has already been confirmed.
Diagnostic Hysteroscopy
A scope and camera is placed into the uterine cavity to allow direct visualization of the uterine lining and openings of the fallopian tubes. This is performed after less invasive diagnostic tests are inconclusive.
Diagnostic Laparoscopy
A scope and camera is placed through a very small incision (usually in the belly button) to allow visualization of the pelvis. This test is performed if less invasive imaging and diagnostic tests are inconclusive or if endometriosis or adhesions are suspected.
Cryo-Storage of Sperm
Sperm can be isolated and stored in liquid nitrogen. This can be useful as a “back-up” specimen in the event of unpredictable sperm production, or as a means to have sperm available when the male cannot be on-site at the time his sperm is needed. Sperm is also cryopreserved when sperm is retrieved during a testicular sperm extraction.