Fertility exam facts
- A fertility exam, or evaluation, assesses a person’s reproductive health and identifies potential barriers to conception.
- Our fertility evaluation begins with a comprehensive medical history followed by diagnostic testing to evaluate general and reproductive health.
- We utilize ultrasound, bloodwork and/or other diagnostic tests in the exam, which may last an hour or so.
- For our patient’s comfort, we recommend patients talk to their physician about possible pain medications that can be taken prior to or after a diagnostic test.
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What is a fertility exam?
A fertility evaluation is an assessment focusing on reproductive function and is an essential step in diagnosing and addressing potential causes of female infertility. The American Society for Reproductive Medicine (ASRM) estimates that about 15% of couples experience infertility.
This fertility exam is designed to evaluate the health of a person’s reproductive system, their hormone levels and anatomic factors that may affect fertility. We do offer telemedicine appointments that can cover some aspects of the fertility exam.
Our Dallas IVF fertility doctors will perform a fertility evaluation to determine whether there are any problems or abnormalities in the reproductive system. The evaluation has two basic components.
- The medical evaluation assesses a patient’s overall health and wellness. Our physician will conduct a thorough and comprehensive review of a patient’s medical, surgical and gynecologic history.
- Our physicians then conduct a basic review of human reproduction and explain why certain diagnostic tests may be necessary for that specific patient or couple.
At Dallas IVF, we customize each assessment based on the initial evaluation, tailoring additional tests and treatments to each individual’s unique needs. Our goal is to provide a thorough understanding of a patient’s reproductive health.
Diagnostic fertility tests
The medical evaluation is a critical component of a patient’s fertility evaluation, but our doctors may also use other tests to develop a clearer understanding of reproductive health.
Ovarian reserve testing is a blood test that assess the quality and quantity of one’s ovulatory egg supply.
Antral follicle count is a vaginal ultrasound exam that allows us to count the resting follicles. This test can estimate the patient’s ovarian reserve and predict their response to medications for ovarian stimulation. If a patient is uncomfortable with a vaginal ultrasound, our physicians will take that into consideration before ordering this test.
Hormone testing and bloodwork are used to evaluate key hormone levels, including:
- Follicle-Stimulating hormone (FSH): Indicates ovarian function and egg quality.
- Luteinizing hormone (LH): Regulates ovulation.
- Anti-Müllerian hormone (AMH): Assesses ovarian reserve (the number of eggs left).
- Estrogen and progesterone: Crucial for cycle regulation and pregnancy support.
Hysterosalpingogram (HSG) is an X-ray exam that involves injecting dye into the uterus to check for blockages in the fallopian tubes. It also provides an excellent opportunity to view the uterus. Additionally, an HSG can help determine if the uterine cavity has any defects like fibroids or polyps. Radio-opaque dye is inserted past the cervix and into the uterine cavity while X-ray images are obtained. HSGs are not always accurate but are considered a very good screening study.
Transvaginal ultrasound is the principal imaging employed by reproductive endocrinologists and gynecologists to evaluate the overall female anatomy. The ultrasound will help assess the condition of the uterus and ovaries. Ovarian masses and uterine fibroids can commonly be seen through this simple diagnostic study. Endometriosis, unless it involves the ovaries and is large, cannot be visualized on ultrasound.
Sonohysterogram, or saline infusion sonogram (SIS) is an in-office procedure, commonly performed to view the uterine cavity. During the transvaginal ultrasound, sterile saline is inserted through the cervix and into the uterus through a narrow tube. This well tolerated procedure allows the physician to see the walls of the uterus and evaluate for the presence of intrauterine growths such as polyps or fibroids. Additionally, a SIS is an excellent screening study to determine the location of fibroids and their relationship to the uterine cavity.
Office hysteroscopy allows our physicians to directly view the uterine cavity. A thin hysteroscope (a small fiber optic camera) is inserted through the cervix and advanced into the uterine cavity. The procedure does not require anesthesia and is very well tolerated. While the hysteroscope cannot visualize the fallopian tubes, it is an excellent diagnostic study to identify fibroids, scarring, polyps or other intrauterine pathology.
Surgical evaluation is sometimes recommended if there is a concern that anatomical problems may interfere with one’s ability to conceive or maintain a pregnancy. Common indications for surgery include blocked fallopian tubes, endometriosis and adhesions (intra-abdominal scar tissue). Common surgical procedures to diagnose and treat infertility include diagnostic and operative hysteroscopy, diagnostic and operative laparoscopy, and abdominal myomectomies (the removal of large fibroids through an abdominal incision). Our physicians have decades of training and experience in performing complicated surgical procedures utilizing the most current techniques to diagnose and treat infertility.
By performing the fertility medical evaluation and fertility diagnostic tests, our doctor can often accurately diagnose the cause of female infertility. An accurate infertility diagnosis leads to effective fertility treatment.
Common new patient questions about Dallas IVF’s fertility exam
How do I prepare for a fertility medical evaluation?
Fill out the medical history questionnaire ahead of your appointment. If you have completed diagnostic testing elsewhere, upload those results to the portal so our physician can review your information ahead of time.
What if an issue is found during the evaluation?
Our fertility specialist will discuss the findings and recommend treatment options or further diagnostic tests as needed.
How long does the medical evaluation take?
The time varies, but the initial consultation is typically only 45 minutes. Additional tests may require separate appointments.
Are these tests painful?
Most tests, like blood draws and ultrasounds, are minimally invasive. Some procedures, such as the HSG, may cause mild discomfort. Ask your doctor if pain medications before your procedure are right for you.
Is a fertility evaluation right for me?
If you’ve been trying to conceive without success, have irregular menstrual cycles or have experienced recurrent miscarriages, a fertility exam can help uncover potential issues affecting your fertility. This evaluation is also beneficial if you’re considering starting a family and want a clear understanding of your reproductive health.
