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FERTILITY
TESTING
You
should seek professional reproductive assistance if you have been
having unprotected intercourse regularly with no pregnancy for a
year or you are over the age of 35 and have been trying for six
month, have irregular menstrual cycles, have had two or more
miscarriages.
Most
Common Fertility Tests
Cycle
Day 3: Baseline tests for follicle stimulating hormone (FSH) and
luteinizing hormone (LH)
LH
should be less than 7mIU/ml
FSH should be less than 13mIU/ml
You
will be asked to use an Ovulation Predictor Kit. When the test is
positive for an LH surge, you will need to take another more blood
tests.
Day
of LH Surge:
LH should be greater than 15mIU/ml
FSH should be greater than 15 mIU/ml
Progesterone should be less than 1.5 ng/ml
7
days Past ovulation:
Progesterone
level testing
Progesterone should be 15 ng/ml
A
Semen Analysis for the male will be scheduled.
Normal
semen values as outlined by the World Health Organization are as
follows:
| PARAMETER |
MINIMUM VALUE
|
| Volume (mL) |
2.0
|
| Sperm Concentration
(million/mL) |
20
|
| Motility (%) |
50
|
| Forward Progression (0-4) |
3
|
| Normal Morphology (%) (WHO) |
30
|
| Normal Morphology (%) (Strict) |
14
|
| Total Sperm Count (million) |
40
|
| Total Motile Sperm (million) |
20
|
| Total Functional Sperm (million) |
6
|
The
day of LH surge prior to ovulation.
Postcoital
test (PCT) to see if the sperm can penetrate and survive in
the cervical mucus and a bacterial screening.
Ultrasound
Exams are used to assess the thickness of the lining of the
uterus, monitor follicle development and assess the condition of
the uterus and ovaries.
After
the initial workup, many doctors continue with some of the following
tests.
HYSTEROSALPINOGRAM
(HSG):
This
test is used to examine a woman's uterus and fallopian tubes. It is
essentially an x-ray procedure in which a radio-opaque dye is
injected through the cervix into the uterus and fallopian tubes.
This "dye" appears white on the x-ray, and allows the
radiologist and your doctor to see if there are any abnormalities,
such as an unusually shaped uterus, tumors, scar tissue or blockages
in the fallopian tubes. If you are trying to get pregnant in the
same cycle as an HSG, make sure to schedule the test PRIOR to
ovulation so that there is no danger of "flushing out" a
released egg or developing embryo. Although most women report only
minor cramping and short-term discomfort during this procedure, some
women, especially those who DO have blockages, report intense pain.
Speak to your doctor about taking a pain medication about 30 minutes
prior to the actual procedure.
HYSTEROSCOPY
If a
uterine abnormality is suspected after the HSG, your doctor may opt
for this procedure, performed with a thin telescope mounted with a
fiber optic light, called a hysteroscope. The hysteroscope is
inserted through the cervix into the uterus and enables the doctor
to see any uterine abnormalities or growths. "Photos" are
taken for future reference. This procedure usually is performed in
the early half of a woman's cycle so that the build-up of the
endometrium does not obscure the doctor's view. However, if the
doctor is planning to do an endometrial biopsy at the same time, it
is done near the end of the cycle.
LAPAROSCOPY
A
narrow fiber optic telescope is inserted through a woman's abdomen
to look at the uterus, fallopian tubes, and ovaries and to discern
endometriosis or pelvic adhesions, and is the best diagnostic tool
for evaluating the ovaries. This test us usually done two or three
days before menstruation is expected, and only after an HCG beta
blood test ensures the woman is not pregnant.
ENDOMETRIAL
BIOPSY
This
procedure involves a scraping a small amountof tissue from the
endometrium shortly before menstruation is due---between 11 and 13
days from LH surge. It should ONLY be performed after an HCG blood
test shows the woman is not pregnant. This test is used to determine
if a woman has a luteal phase defect --- a hormonal imbalance which
prevents a woman from sustaining a pregnancy because not enough
progesterone is produce
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