Female Infertility Tests May Include Blood Work and Ultrasounds
An ultrasound is typically done the day of your initial visit to determine if there are any problems that need to be addressed before treatment. An ultrasound can often diagnose such abnormalities as uterine fibroids, uterine polyps, ovarian cysts and uterine birth defects.
HSG or Hysterosalpingagram
The HSG (hysterosalpingagram) is a test to determine if the fallopian tubes are open and to make sure that the uterine cavity is normal. It is performed in a radiology department because x-ray is necessary to allow us to adequately visualize the pelvic organs.
After placing a speculum in the vagina, a small tube (catheter) is placed through the cervix into the uterus. Next, dye is placed into the uterus. The dye should fill the uterus and the fallopian tubes and then spill into the pelvis. A normal test will show dye spilling from both tubes. This means the tubes are patent or open.
Abnormal results could include a lack of dye filling one or both tubes or lack of dye spilling from a tube, indicating a blockage. Hydrosalpinges (dilated tubes) can also be seen on an HSG. An abnormal test might be further evaluated with surgery or IVF may be recommended, depending on the type of abnormality revealed by the xray. In addition to tubal conditions, uterine abnormalities such as endometrial polyps, uterine fibroids, abnormalities in the uterine cavity shape, and/or intrauterine scar tissue can also be diagnosed with an HSG. The HSG will be performed any day between cycle day 6 and 11, with cycle day 1 being the first day of your period.
Blood work will include an evaluation of ovarian reserve which means how many eggs are remaining in the ovaries. This blood work includes FSH (follicle stimulating hormone) & AMH (anti-mullerian hormone). Typically this bloodwork will be done cycle day 2, 3 or 4 where cycle day 1 is the first day of your period. The transvaginal ultrasound will aid in determining ovarian reserve by counting the number of antral follicles (small cysts containing an egg) present in the ovaries early in the menstrual cycle.
A saline sonogram may also be recommended to evaluate the uterine cavity. Unlike the HSG described above, this test is performed in the office, as no X-ray is needed. Like the HSG, during the test, a catheter is placed through the cervix into the uterus and water is placed in the uterine cavity while an ultrasound is performed. This test can also diagnose polyps, fibroids, & an abnormally shaped uterus.
Our team may recommend screening for specific genetic disorders based on your family history. You may also elect to have genetic screening for genetic disorders for which you could be a carrier even if you have no family history of the disorder. Both the American Congress of Obstetricians and Gynecologists and the American College of Medical Genetics have recommended screening panels for more common genetic conditions such as cystic fibrosis (CF) or muscular diseases, or you may choose a more comprehensive panel because of your history. Our physicians are ready to answer your questions and help guide you to choosing the right test for you and your future family.