What Tests are Needed?
What tests are important?
Some
procedures, such as blood testing, are fairly simple; others, such as a
hysterosalpingogram or even surgery, can be more invasive. The following tests
are usually recommended in a basic work up.- Day 3 follicle stimulating hormone (FSH) and
estradiol.
Measuring the FSH on day 3 of the menstrual cycle is a good
way to evaluate egg quality. Estradiol measurements confirm the accuracy of the
test. FSH should be less than 12. This hormone is necessary for the maturation
of an egg each month, and elevated levels may indicate diminished ovarian
reserve.
- Estradiol (an estrogen) on day 3 of the cycle should be greater
than 10 but less than 50.
An elevated estradiol may indicate the presence of an ovarian
cyst or other fertility-related concerns. Very low levels may
indicate that the ovaries are suppressed and may not respond to
stimulation.
- Hysterosalpingogram.
*An HSG is an x-ray that shows the interior contour of the uterus
and fallopian tubes. This test is important because it can detect
irregularities inside the uterus that could interfere with fertility.
It also lets us know if the tubes are open so that the sperm and
egg can meet. The HSG is performed by injecting a special dye
through the cervix and observing the flow of the dye through the
uterus and tubes on x-ray. Because an HSG is an x-ray, it must
be performed in a facility that offers this service. We usually
refer patients to the Women's Diagnostic and Breast Center in
the Margot Perot Building of Presbyterian Hospital or to Southwest
Diagnostic Imaging Center in Professional Building 3 at Presbyterian
Hospital. If you prefer to use another location, you may do so.
An HSG must be done between menstrual cycle day 6 and 10. To schedule
the procedure, please call our nurse on day 1 or 2 of your period
and she will assist you. *You will be given an antibiotic to take
for 5 days beginning 2 days before the HSG to reduce the risk
of any infection. We also recommend that you take 2-3 ibuprofen
tablets one hour before your appointment because some women experience
mild to moderate cramping during the procedure. Patients are usually
able to drive themselves home, but you may wish to have someone
accompany you.
- Semen analysis.
Evaluation of the male partner's sperm is an essential part of
a fertility work-up. To obtain the most accurate results, the
test should be performed in a lab that specializes in semen analysis.
These labs use a very specific method of analyzing the shape of
the sperm as well as the number and motility (ability to swim).
*We will provide you with a specimen cup and instructions provided
by the Presbyterian Hospital of Dallas ARTS lab located in the
Margot Perot Buiding, or at Presbyterian Hospital of Plano ARTS
lab * Please schedule an appointment for a semen analysis by calling
214-345-2624(PHD) or 972-981-3326 (PHP). Semen analysis are performed
between 8:30-11:30 a.m. Monday through Thursday. If you live more
than one hour from the hospital, we ask that you collect the sample
at the ARTS lab which has rooms available in a comfortable environment.
The male should abstain from intercourse or ejaculation for at
least 2 days, but no more than 4 days, prior to the day of collection.
If collected at home, keep the sample at body temperature while
bringing to the facility. All specimens should be clearly labeled
with the label placed on the cup itself. The cup is then placed
in a clear biohazard bag, and this is placed in the bag provided
by the ARTS laboratory.
- Ultrasound
A pelvic ultrasound is very useful
when done at the appropriate time in the cycle. Done a few days prior to
ovulation, ultrasound can evaluate impending ovulation and assess the thickness
and pattern of the endometrial lining, where the fertilized egg would implant.
Polyps, fibroids and ovarian cysts can also be identified on ultrasound. This
procedure is usually performed in the office.
- Hysterosonogram
This test may be performed to evaluate the uterine cavity specifically.
This test involves injecting a saline solution through the cervix
into the uterus while imaging the uterus with a sonogram.* This
test may also be performed in the office. This allows the physician
to visualize any irregularities that might interfere with fertility.
It does not evaluate the tubes and does not take the place of
an HSG. Sonohysterography fills the uterine cavity with saline,
outlining the polyp which could not be discretely seen with routine
ultrasound.
Genetic testing
Genetic testing is not
often necessary, but is important in women with premature menopause or multiple
miscarriages. It is also valuable in men with very low sperm counts. The
American College of Obstetricians and Gynecologists recommends that genetic
testing for cystic fibrosis be offered to all couples attempting
conception. If your family tree does hold a genetic problem or birth
defect, you'll probably want to have genetic testing done. If you are a known
carrier of a disease such as Tay-Sachs, cystic fibrosis or sickle cell anemia,
you will want to have your partner tested as well. These are recessive
diseases, and therefore only if both partners are carriers are you at risk of
having an affected child. If a couple are both carriers for cystic fibrosis,
preimplantation genetic diagnosis (PGD), can be performed on embryos from an
IVF cycle. Unaffected embryos can be transferred to the uterus or frozen for
future transfer.
|  | Fertility Specialists of
Dallas
Phone: 214.750.5500
Presbyterian Hospital of
Dallas
8230 Walnut Hill Lane Suite 300
Dallas, TX 75231
Click here for
Directions
Presbyterian Hospital of Plano
6300 W.
Parker Rd
Bldg II, Suite 424
Plano, TX 75093
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Directions
Texarkana Satellite
1002 Texas Blvd Suite 401
Texarkana, TX 75503
903.793.5500
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