Basic Fertility Testing in NYC
At our NYC fertility clinic, we commonly use baseline hormonal blood tests, baseline pelvic ultrasounds, hysterosalpingogram (HSG), and semen analysis in the initial evaluation of infertility. If infertility is discovered, we will determine the cause and which of our fertility treatments is right for you. Our fertility clinic has enabled thousands of infertile couples to become parents. Learn more about our infertility tests for women and men below, or request a consultation today using the form on this page.
Baseline Hormonal Blood Tests
The reproductive hormones estradiol (E2), FSH, LH, prolactin, and AMH are measured on Day 2 or Day 3 of the menstrual cycle.
- They must be within a normal range during the cycle of treatment in order to proceed with the treatment.
- These hormone levels change from month to month, so infertility patients must do this every month during their fertility care.
Baseline Pelvic Ultrasound
This test shows the condition of the uterus and the ovaries at the start of the menstrual cycle.
- Besides showing their measurements, it also shows whether there are fibroids in the uterus or cysts in the ovaries.
- More importantly, it shows the number and size of ovarian follicles (egg-bearing sacs) available for growth and development during this particular cycle.
- For IVF patients, these follicles represent those that can be stimulated in order to obtain at least eight mature eggs that can be retrieved for IVF.
A hysterosalpingogram is an X-ray of the uterus and the fallopian tubes, which shows:
- Any defects within the uterine cavity (the space where the baby will grow) or its lining.
- Any anatomical abnormality that may need to be corrected surgically before proceeding to fertility treatment.
- Whether the fallopian tubes are open or blocked.
- Blocked tubes were the original indication for IVF – because IVF bypasses the tubes for fertilization.
- If your tubes are blocked, partially or totally, whether from pelvic inflammatory disease (PID) when you were younger or because you had tubal ligation or had your tubes cut off, the HSG will show whether there is any inflammation (hydrosalpinx) that would require surgery to cut off the tubes completely before you can undertake IVF. Studies have shown that the fluid from a hydrosalpinx is toxic to embryos.
Semen Analysis with Strict Morphology
This is the only preliminary fertility testing that most male partners have to do. It must be done at a laboratory that specializes in semen testing, and not in any general laboratory. The test will show:
- The semen volume (in cubic centimeters, cc)
- The number of sperm cells per cubic centimeter (in millions/cc)
- What percent of the sperm are moving and how fast they move
- The shapes (morphology) of the sperm cells
Normal sperm cells have oval heads without shape defects and uncurled tails, but the majority of sperm cells have an abnormal morphology. In most men, even fertile men who have had many children, the lower limit for normal-shaped sperm cells is 14%. For infertility patients, >4% is considered a fair prognosis.
Time Involved in Basic Fertility Testing
- The first three tests for the female partner can usually be done in the first ten days of a menstrual cycle.
- The male partner can do the semen analysis anytime, after abstaining from sex for three days, and provided he has not had any recent fever or infections.
Therefore, it is possible to have the initial evaluation completed quickly, which will enable us to identify the possible cause or causes of the couple’s infertility. In one-third of fertility patients, the cause is female only; in another one-third, male only; and in the rest, there are both female and male factors.
If the initial tests do not indicate the cause of infertility, our doctors may propose further tests such as a pelvic MRI, if necessary, to more fully characterize a pelvic factor that also involves the uterus and the ovaries. Any surgery necessary to identify significant factors like endometriosis (which can only be diagnosed definitively with surgery) and correct problems that should be resolved before proceeding to IVF.