Diagnostics & Evaluation
The Infertility Evaluation consists of a series of tests that can evaluate both male and female reproductive function.
The objective of the evaluation is to identify potential causes of infertility, or to update any testing that may be outdated and required prior to proceeding with treatment.
Accordingly, Dr. Sueldo may order some or all of the following tests depending on your individual case.
01 | Bloodwork (aka Hormone Testing)
An important factor that influences a woman’s fertility is the number of eggs she has to work with during treatment, and this quantity can be assessed by hormone testing.
Between days 2–4 of the menstrual cycle, a blood sample can be obtained for the measurement of follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) hormone. Anti-Mullerian Hormone (AMH) is another hormone used to assess egg quantity, or ovarian reserve, and can be checked at any time of your menstrual cycle.
Lastly, there are some pre-pregnancy laboratory tests that may be important for your reproductive health and pregnancy. These may include things like your blood type, a thyroid level, among others. Dr. Sueldo & her team will individualize each blood draw depending on your unique case.
02 | HyFoSy (Checking your Fallopian Tubes)
You may have heard about the HSG test to check your fallopian tubes. Well, this is similar but different. A HyFoSy is an ultrasound study that is performed to examine the uterus and determine whether your fallopian tubes are open.
It is FDA-approved, less painful than the HSG, and has a 93.7% accuracy rating, when compared to the HSG (Positive Predictive Value and Negative Predictive Value are 38% and 94%, respectively).
First launched in Europe in 2011, the FDA-approved ExEm® Foam has been used in over 500,000 foam procedures worldwide, allowing for a safe, successful alternative to X-Ray HSG, laparoscopy or (Saline-Air) HyCoSy.
03 | Sonohysterogram (aka SIS or Saline Infusion Sonogram)
The sonohysterogram is a test that examines the uterine cavity and is sometimes done in lieu of or in conjunction with the HyFoSy test.
Fluid is put into the uterus through the cervix using a very small catheter. Sound waves are then used to create images of the lining of the uterus. Remember, that the uterus is normally collapsed on itself, so the fluid helps to open up that space and show more detail of the inside of the uterine cavity than when ultrasound is used alone.
04 | Genetic Carrier Screen
At Ceibo Fertility, all patients are offered genetic carrier screening as part of their evaluation and we are currently using the Horizon test from Natera for that assessment.
There are different ways genetic conditions can be passed down or inherited in families. We carry two copies of most of our genes, one inherited from each of our biological parents. Some genetic conditions happen when only one gene in a pair has a change. These are called dominant genetic conditions. Horizon carrier screening does NOT screen for dominant genetic conditions. Horizon carrier screening tests for genetic conditions that happen when both copies of a gene pair have a change. These are called recessive genetic conditions.
For more about the Horizon test, please visit their website:
05 | Endometrial Biopsy
An endometrial biopsy is an office procedure that involves the removal of a small amount of tissue from the uterine cavity.
A pathologist will then examine the biopsy. Any woman who has a history of abnormal bleeding, irregular or absence of menstrual periods, or a history of a biopsy confirming an infection may benefit from the performance of an endometrial biopsy. The endometrial biopsy is not a routine test and is done in selected cases.
06 | Semen Analysis
If a male patient sees the fertility doctor, the semen analysis is the standard test for the evaluation of their fertility.
The semen analysis includes an assessment of the sperm concentration, motility (or activity of sperm), and a determination of the percentage of normally shaped sperm. If the initial semen analysis is found to be abnormal, then a repeat analysis may be requested.