General female fertility diagnostic procedures

Blood testing

Several blood tests will be performed at CReATe on each partner (if applicable) when trying to diagnose and treat fertility problems. Some examples include estrogen, luteinizing hormone (LH), follicle stimulating hormone (FSH), progesterone, thyroid stimulating hormone (TSH), androgens, and the pregnancy test hormone (β-HCG). We also perform a very important new hormone test called anti-müllerian hormone (AMH) at CReATe on many patients. AMH is an excellent predictor of the number of eggs a person has left in their ovaries, which is called ovarian reserve. There are also a number of other blood tests that may be helpful in the evaluation and treatment of infertility or recurrent pregnancy losses. Some examples include testing for immune and genetic problems. The specific tests your doctor will order on each partner will depend on your specific circumstances.

Ultrasound services

The use of ultrasound to evaluate a women’s reproductive organs is extremely important when diagnosing and treating fertility problems. We use ultrasound for initial evaluation and for monitoring the ovaries and uterine lining during the menstrual cycle. We also use ultrasound when harvesting eggs during in vitro fertilization (IVF) and to help transfer the embryos produced back to the uterus. Once a pregnancy is established, we also use ultrasound at CReATe during the first 3 months to check the pregnancy progress and to check for abnormalities in the fetus.

Sonohysterogram (uterus cavity check)

Uses ultrasound to evaluate the inside of the uterine cavity. Involves the injection of saline solution into the cavity of the uterus. We perform these Monday – Friday starting between 10:30 and 11:00am.

Hysterosonogram (tube check)

This test involves injecting dye into the cervix to determine whether your fallopian tubes are open or blocked. We perform these on Tuesdays and Thursdays at 2pm at CReATe.

Office hysteroscopy (uterus cavity check and repair)

Procedure to examine the inside of the uterus using a narrow telescope. This is performed under intravenous sedation to avoid discomfort. If something is found that could affect your fertility, then we can usually treat it at that time. Some of the problems we may find and treat at the same time are: polyps, fibroids, scar tissue, and abnormalities from birth, such as a septum.

Hospital hysteroscopy (in a hospital operating room) (uterus cavity check and repair)

In some cases, office hysteroscopy (see above) cannot be used to treat a problem inside the uterus such as large fibroids. In this case, hysteroscopy must be performed in a hospital under general anesthesia. Hysteroscopy can also be performed during the same operation as laparoscopy.

Laparoscopy

This is a day surgery procedure performed in the hospital operating room under general anesthesia. The operation involves the insertion of a thin diagnostic telescope through the navel (belly button) and one to three small incisions elsewhere for manipulation. Using a laser and other instruments, your doctor can diagnose and treat conditions that could be affecting your fertility such as, endometriosis and scar tissue. In addition, the tubes can be checked for blockages.

Basic Fertility Treatments

Natural Cycle Monitoring

Non-medicated monitoring of a patient’s cycle through a combination of hormonal blood tests and ultrasounds, which are used to give a biological profile of a patient’s ovulation status. Click here for patient instructions.

Ovulation Induction

Stimulation of ovaries using medication to induce ovulation. This process may result in the release of more than one egg or oocyte. As a result, there is often an increase in multiple pregnancies after ovulation induction. For each medication, the risk varies. This should be discussed with your doctor.

Intrauterine Insemination

During IUI, your doctor will place washed, prepared sperm into your uterus (womb) and near to your egg at your time of ovulation. This procedure is often combined with fertility drugs to increase your chances of conceiving.” Click here to see a 3D animation of an IUI.