Evaluation & Diagnosis

The causes of infertility are not always easily recognizable. Our specialists may recommend a variety of diagnostic tests that can help determine how to proceed. We begin with a one-on-one consultation, a medical history review, and baseline tests for each partner, to evaluate female hormone levels and egg quality, and male sperm count.

Please bring your medical records to your first appointment. These records contain important information about your personal and family health history, your gynecologic history, and any previous infertility work-ups and treatment. Dr. Miller will reference this important data when planning your treatment.

Given the importance of the ground covered during the work-up stage, we strongly ecnourage both partners to attend. Once your work-up is complete, our physicians will meet with you and your partner to discuss the findings and recommended treatment plan.

WHEN TO SEE A DOCTOR

The National Infertility Association says that most physicians will recommend that couples try to conceive for a year before seeking medical assistance. They also state that if a woman is over 30, has a history of pelvic disease, miscarriage, painful menstruation, irregular cycles, or if her partner has a low sperm count, they may want to seek professional advice sooner.

HOW TO CHOOSE A SPECIALIST

Choosing the right place for infertility treatment is very important. According to the American Society for Reproductive Medicine, there are certain points that need to be considered when making that choice:

  • Qualifications and experience of the people who work in the facility
  • Types of patients being treated (this can have an effect on a program’s pregnancy success rate; e.g., couples over forty are less likely to get pregnant than younger couples)
  • Support services available – some programs may just have IVF or GIFT or they may combine more than one, but you want to be sure they have all services that you may need
  • Cost
  • Convenience
  • Documentation to support their success rates
  • Details about the guidelines they follow, lab accreditations, and statistic reporting

Click here to find the best infertility treatment clinics.

TESTING
Tests may include:

  • Semen analysis to evaluate ejaculate; the specimen is collected after 2 to 3 days of complete abstinence to determine volume and viscosity of semen and sperm count, motility, swimming speed, and shape.
  • Postcoital test (PCT) — to evaluate sperm-cervical mucus interaction through analysis of cervical mucus collected 2 to 8 hours after the couple has intercourse.
  • Measuring serum progesterone (blood test)
  • Endometrial biopsy to determine response of the uterine lining.
  • Testicular biopsy (rarely done)
  • Measuring urinary luteinizing hormone by using kits commercially available for home use to predict ovulation and assist with timing of intercourse.
  • Serum hormonal levels (blood tests) for either or both partners. For women this may include estrogen, TSH, prolactin, inhibin B, antimullerian hormones, LH, and FSH. For men tests may include LH, FSH, TSH, prolactin, and testosterone.
  • Hysterosalpingography (HSG) — X-ray procedure done with contrast dye that enables evaluation of potential transport from the cervix through the uterus and fallopian tubes.
  • Laparoscopy to allow direct visualization of the pelvic cavity.
  • Hysterosonogram – an ultrasound test involving filling the uterine cavity with saline to evaluate for abnormalities.
  • Ultrasound to evaluate uterine health.