Diagnostic Testing for Fertility
The first step in overcoming infertility is correctly diagnosing the cause of your infertility. Is ovulation occurring normally? Are your fallopian tubes open? Are the sperm normal and functional? By helping us determine the root cause or causes, we can better understand which treatment options will be most effective. Many times, diagnostic testing can be initiated during your initial visit immediately following your consultation with Dr. Kelly. The results of the initial testing will tell us whether further diagnostic testing is necessary. If it is, we’ll schedule that to be done at your next appointment.
The Fertility Evaluation
Diagnostic testing typically includes a physical exam, a pelvic ultrasound, and blood work to determine levels of specific fertility related hormones. Preconception and genetic screening for mutations which might place a child at risk will be offered to you.
Physical Exam
During the physical exam, Dr. Kelly looks for any obvious cause for infertility or issue that would interfere with you carrying a pregnancy.
Pelvic Ultrasound
The pelvic ultrasound provides more in-depth information on the reproductive organs. It helps identify issues like fibroids, ovarian cysts, PCOS, endometrial polyps and ovarian reserve . Ultrasounds performed at specific times during the hormonal cycle can provide evidence of ovulation through follicle growth and proper development of the lining of the uterus for implantation.
Hormonal Levels
Measuring hormone levels in the blood can provide a wealth of information for Dr. Kelly to assess infertility. These levels can indicate whether a woman is ovulating, the reason she may not be ovulating, the environment in which the egg is maturing and the likely quality of the eggs being released. These tests are specific to certain times in a menstrual cycle and are carefully mapped out. Hormonal levels measured in men may at times give insight into why a semen analysis is not normal or why sexual dysfunction is occurring and whether or not medication may help.
Semen Analysis
A semen analysis assesses the sperm concentration, morphology, motility, and progression. Sperm concentration is the number of sperm in a sample. Sperm morphology is the percentage of sperm in a sample that has a normal shape, which represents their ability to swim and penetrate the egg. Sperm motility represents whether the sperm are moving, and sperm progression indicates how well the sperm are moving.
Further Diagnostic Testing
A complete fertility evaluation includes assessment of the uterus and fallopian tubes. The most common of these tests include:
Hysterosalpingogram (HSG)
An HSG allows us to see the shape of the uterus and whether or not the fallopian tubes are open. It is an X-Ray study in which contrast fluid or dye is injected into the cervix and is monitored as it travels through the uterus and fallopian tubes. The test is performed by Dr. Kelly in the radiology department at Pennsylvania Hospital.
Sonohysterogram (SIS)
The Sonohysterogram, also known as Sono HSG, Sonogram, or SIS, is a procedure done in our office in which sterile water is injected into the uterus and the uterine cavity is visualized by ultrasound.
Hysteroscopy
During a hysteroscopy a small telescope is passed through the cervical canal and directly visualizes the interior of the uterus. This can be done in the office to further assess abnormalities suggested on an HSG or SIS
