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Fertility Testing For Women

Embryologist putting sample into centrifugeAt Fertility CARE, our first goal during your initial visit is to place you at ease. Before performing any tests, we explain our approach to your care and answer any questions you may have. We take time to explain your reproductive anatomy and any factors that may be contributing to a fertility problem.

Following a thorough medical interview, we offer you a comprehensive physical examination and pelvic ultrasound. At the conclusion of your visit we outline a thorough infertility evaluation to determine the cause of your fertility problem.

Evaluation

The evaluation may include one of the items listed below. Click the title of each item to discover more:

An endometrial biopsy is a minor office procedure and involves placing a small catheter through your vagina into your uterus to remove a small sample of the lining (endometrium) for microscopic examination. Common reasons for performing this test are to:

  • Evaluate abnormal uterine bleeding to determine if your lining is over-developed (endometrial hyperplasia)
  • Detect the presence of an important protein needed for embryo implantation (integrin) 
  • Calculate if the lining is being prepared correctly by your hormones to receive the embryo or deficient (luteal phase defect)

Test results are usually available within ten days.

A hormone is a steroid in your blood produced from one organ and having its function on other parts of the body.

Female hormones (estradiol and progesterone) fluctuate based on your menstrual cycle and are involved in the development of eggs, ovulation, and implantation of the embryo in the uterus.

For this process to occur effectively, hormones must be produced in a specific amount and time. Other reasons for testing include evaluation of ovarian age, thyroid and adrenal gland function. Levels are measured by a blood sample in the office.

A hysterosalpingogram (HSG) is a specialized office x-ray procedure that determines if the fallopian tubes are open and if the uterus is of normal shape.

The HSG is performed following completion of your menstrual flow and before ovulation, usually between cycle days 6-12. An antibiotic is prescribed to reduce the risk of infection. Ibuprofen (Motrin, Advil) is usually taken 30 minutes prior to the test to minimize cramping.

The procedure involves placing a small catheter through your vagina and into the cervix to inject a small amount of contrast dye and observe the liquid filling the uterus and flowing through the tubes. Please inform your doctor if you are allergic to contrast dye, iodine, seafood/shellfish to avoid an allergic reaction to the HSG dye.

Hysteroscopy is a method of examining the inside of the uterus using a small, lighted telescope (hysteroscope). Conditions that can be treated by hysteroscopy include:

  • Fibroids
  • Uterine scarring
  • Polyps
  • Congenital malformations

A diagnostic hysteroscopy can be done in our office during menstrual cycle days 6-12.

A tiny, flexible, lighted telescope is passed into your vagina and through your cervix into the uterus. A small amount of saline is injected through the scope to allow for better visualization of the uterine cavity. Images of the uterine cavity will be projected on a monitor so you can watch. If abnormalities are discovered, an operative hysteroscopy will be scheduled. The procedure normally takes less than 5 minutes and involves minimal to no cramping.

An operative hysteroscopy is performed under sedation or general anesthesia. Anesthesia is required because your cervix must be dilated to allow instruments into your uterus to correct conditions such as removal of scar tissue, polyps, or congenital abnormalities such as a uterine septum.

Laparoscopy is an outpatient surgical procedure to view the pelvic organs by using a small, lighted telescope (laparoscope) inserted through the abdomen at the belly button. This procedure is used to diagnose and treat problems such as blocked fallopian tubes, endometriosis, ovarian cysts, or adhesions (scar tissue) all of which may impact fertility.

A laparoscopy is performed under general anesthesia. After you are asleep, a needle is inserted through your 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 in the cavity to treat your condition.

When the procedure is complete, the gas is removed from your abdomen, the incisions are closed, and you are taken to a recovery room. When the effects of anesthesia have worn off you may return home and continue your recovery for a few days prior to resuming activity and work. A two-week follow-up appointment will be scheduled prior to the procedure.

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.

Frequently Asked Questions

woman-1148923_640When is a woman’s most fertile time?

The most fertile time for a women is during ovulation. Ovulation typically occurs within day 11 through day 21 of a woman’s cycle.

Is infertility a medical problem related to the woman only?

Medical conditions like infertility can be found in both men and women, and both can be affected almost equally. Common causes of infertility for men can include declining sperm counts, testicular abnormalities, and decreased reach of climax. The most common conditions in women are tubal blockage, endometriosis, PCOS and advanced maternal age which affects egg quality/quantity.

How common is infertility?

Infertility currently affects about 6.1 million American couples (approximately 10% of American couples of childbearing age). About 25% of the 6.1 million infertile couples have multiple causes of infertility.

How long should a couple try to conceive before going to the doctor?

If you are a female and 35 years old or younger, it’s recommended to try for one year before considering scheduling a meeting. If you are 35 or older, six months of trying is considered the recommended amount to try before scheduling a meeting. This recommendation is in accordance with the American Society of Reproductive Medicine guidelines.

Can you find out earlier if you have fertility issues?

You always have the option to complete an examination at anytime to determine if you or your partner has fertility issues. At-home fertility testing is also available for both men and women.

The IVF Center – Why Fertility CARE is Unique

Dr. Trolice and the team supporting Breast Cancer Awareness month.

Dr. Trolice and the team supporting Breast Cancer Awareness month.

At Fertility CARE we recognize the process of IVF can at times be overwhelming.

To address this issue, we have an IVF Nurse available 24/7 to answer questions, guide you through the process, and provide emotional support. We also offer a Reproductive Health Psychologist to help couples develop their best coping strategies along their journey.

Success of the IVF Program at Fertility CARE is due to our scientific and technological excellence coupled with our compassionate and highly personalized approach to patient care.

Fertility CARE is committed to each couple’s success by providing individualized and supportive care along the way. We consider each couple part of our family as we attempt to help them create their own.

What our Patients are Saying

“They’re the reason I’m a mom to a very healthy 5 year old boy! The nursing staff was amazing and made a difficult process easier.”

Fertility CARE Patient, Facebook Review

“I had a great experience with Dr. Trolice and his staff, they were always friendly and helpful. I felt comfortable asking any question and really appreciated Dr. Trolice’s willingness to allow my husband and I to be so involved in forming our treatment plan.”

Fertility CARE Patient, RateMds.com Review

“We can’t thank Fertility CARE and Dr. Trolice enough for their compassion and expertise. Their concern during every step of our journey was invaluable. We have gone to other fertility doctors before Dr. Trolice and keep kicking ourselves for not going to Dr. Trolice first!”

Fertility CARE Patient, Vitals.com Review

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