
We perform the entire infertility work-up, which involves an initial consultation, hormonal measurements, ultrasound studies and follicle monitoring, hysterosalpingography (if needed), laparoscopy and hysteroscopy (if necessary), and genetic testing (when indicated). Not every patient requires all the test.
Medical history: your previous health, surgical history and family history may provide some clues about the cause of infertility.
Menstrual history: Amenorrhea (absent menstrual periods) usually signals an absence of ovulation, which can cause infertility. Oligomenorrhea (irregular menstrual cycles) can be a sign of irregular ovulation; although oligomenorrhea does not make pregnancy impossible, it can interfere with the ability to become pregnant.
Physical examination: A physical examination usually includes a general examination, with special attention to any signs of hormone deficiency or signs of other conditions that might impair fertility.
Blood tests: Blood tests can provide information about the levels of several hormones that play a role in female fertility. In women, the key hormones are produced by the hypothalamus, the pituitary gland, and the ovaries. These hormones include Antimullerian hormone (AMH),follicle-stimulating hormone (FSH), Luteinising hormone (LH) and estrogen levels to assess how well the ovaries are functioning, TSH to test thyroid function, and prolactin to assess the presence of a benign pituitary tumor.
Tests to evaluate ovulation: Ovulation (the release of an egg from an ovary) is essential for fertility. Abnormalities of ovulation can often be determined from a woman’s menstrual history or hormone levels such as the pre-ovulatory LH surge or luteal phase progesterone levels (day 21 of the cycle) or with serial ultrasounds called follicle monitoring.
Tests to evaluate the uterus and fallopian tubes: Uterine abnormalities that can contribute to infertility include congenital structural abnormalities, such as a uterine septum (a band of tissue that makes the uterine cavity); fibroids; polyps; and structural abnormalities that can result from gynaecologic procedures.
Scarring and obstruction of the fallopian tubes can occur as a result of pelvic inflammatory disease, endometriosis, or pelvic adhesions (scar tissue) from abdominal infection or surgery.
- Hysterosalpingogram (HSG)
- Hysteroscopy
- Laparoscopy
- Genetic tests