Fertility Testing for Women

At Fertility Specialists of Houston, our top priority is the comfort of our patients during this stressful time. Before we begin with testing, we thoroughly detail our approach to your care and answer all questions you might have. We then take the time to explain your reproductive anatomy and any factors that could be contributing to infertility. During your initial visit, our doctors will obtain a detailed medical history from you. At the conclusion of your visit, our physicians will outline a comprehensive infertility work-up to determine the cause of your fertility problem. The evaluation may include the following recommendations:

Hormonal Studies

Hormones are steroids in your blood produced from one organ and having its function on other parts of the body. Female hormones include estradiol and progesterone and fluctuate based on your menstrual cycle. Both hormones are involved in the development of eggs, ovulation and implantation of the embryo in the uterus. For the process to occur effectively, hormones must be produced in a specific amount and at a specific time. Reasons for testing include the evaluation of ovarian age, thyroid and adrenal gland function. Hormone levels are measured by a simple blood sample in the our office.

Ovarian Reserve

Ovarian reserve testing (ORT) is a procedure our physicians perform that is used to evaluate the function and quality of the ovaries. The testing does not determine whether you are ovulating or not because it is possible to be regularly ovulating but have poor quality eggs. By doing ORT, our doctors can gain a better idea of how likely you are to get pregnant, and which fertility treatments may be best for you.

Results from ORT fall into two categories: normal or poor. Receiving a diagnosis of normal ovarian reserve does not guarantee that you will become pregnant. It simply indicates that your ovaries appear to be working properly, and that you have normal quality of eggs in your ovaries. Poor ovarian reserve can indicate that pregnancy is less likely to occur, or that it will be exceptionally difficult to conceive.

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Hysterosalpingogram (HSG)

A hysterosalpingogram (HSG) is an out-patient x-ray procedure performed in a hospitalthat is used to determine whether the fallopian tubes are open and if the shape of the uterine cavity is normal.

The HSG is performed following completion of your menstrual flow and before ovulation -- usually between cycle days six through 12. An antibiotic is prescribed prior to the procedure to reduce the risk of infection and Ibuprofen is recommended 30 minutes prior to the test to minimize cramping.

The procedure involves placing a small catheter through the vagina and into the cervix. Our physicians will then inject a small amount of contrast dye and observe the liquid filling the uterus and flowing through the tubes.

After the HSG, a patient can immediately resume normal activities, although some physicians ask that the woman to refrain from intercourse for a few days.

Please inform your doctor if you are allergic to contrast dye or iodine to avoid an allergic reaction to the HSG dye.

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Sonohysterogram (SHG)

A sonohysterogram (SHG) is very similar to a hysterosalpingogram (HSG), but instead of injecting dye, a small amount of saline is placed into the uterus and then is viewed via ultrasound to check for defects in the lining of the uterus which could prevent implantation of the egg or cause miscarriage.

The test is an outpatient procedure performed in our office in the first half of the reproductive cycle to ensure that you are not pregnant at the time of the procedure.

This procedure is relatively painless, and some patients choose to take ibuprofen one hour prior to their SHG to minimize the cramping.

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Laparoscopy

Laparoscopy is an outpatient surgical procedure that allows our physicians to see a direct view of a woman's reproductive organs. This procedure can help the doctor diagnose and treat problems such as blocked fallopian tubes, endometriosis, ovarian cysts, adhesions (scar tissue) or other possible problems that could cause infertility. The procedure is done by inserting a small, lighted telescope (laparoscope) inserted into the abdomen through the belly button. A laparoscopy is performed under general anesthesia. Once the patient is asleep, a needle is inserted through her belly button and the abdomen is filled with carbon dioxide gas. The gas pushes the internal organs away from the abdominal wall so the telescope and any necessary instruments can be used view the pelvis and treat her condition.

When surgery is complete, the gas is released from the patient's abdomen, the incisions are closed and they are taken to the recovery room. When the effects of anesthesia have worn off, the patient may return home where they will continue to recover for a few days prior to resuming activity and work. Our doctors will schedule a follow-up visit a one to two weeks following the procedure to check the incisions and monitor our patient's health.

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Hysteroscopy

Hysteroscopy is similar to a laparoscopy, but it is used to examine the inside of the uterus rather then the outside of the reproductive organs using a small, lighted telescope. There are many conditions that can be treated by hysteroscopy including: fibroids, uterine scarring, polyps and congenital malformations. An operative hysteroscopy is performed under general anesthesia. Anesthesia is required because the patient's cervix must be dilated to allow instruments into their uterus to correct conditions such as removal of scar tissue, polyps or congenital abnormalities such as a uterine septum.

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Ultrasound

Ultrasound is a method to view your reproductive organs using high frequency sound waves that bounce off of body structures to create pictures on a monitor. The method most commonly used in fertility practices is transvaginal ultrasound. This refers to a probe that has been covered with a condom and placed into the vagina for close proximity to the pelvic organs.

Transvaginal ultrasound (TVUS) is used to diagnose conditions such as ovarian aging, uterine fibroids, ovarian cysts or early pregnancy. During your fertility treatment cycles, TVUS is used to monitor development of follicles (cysts containing microscopic eggs) and during the egg retrieval of an In-vitro Fertilization (IVF) cycle to help the physician guide a needle into the follicles and retrieve eggs.

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Endometrial Biopsy

An endometrial biopsy is a minor procedure that can be performed in our office, and involves placing a small catheter through your vagina into your uterus to remove a small sample of the endometrium lining for examination. This test is performed to evaluate possible abnormal uterine bleeding, and to determine the following:

Test results are usually available within a week to 10 days.

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* The site is not a replacement for professional medical opinion, examination, diagnosis or treatment. Always seek the advice of your medical doctor or other qualified health professional before starting any new treatment or making any changes to existing treatment. Do not delay seeking or disregard medical advice based on information written on this site. No health information on this website should be used to diagnose, treat, cure or prevent any disease without the supervision of a medical doctor.