Based on your individual history, your doctor will order specific tests to evaluate your infertility. Your treatment will be based your specific diagnosis resulting from infertility tests. Houston IVF’s infertility evaluation will include testing to assess the male partner, ovulatory function, the fallopian tubes, the uterus and the cervical mucus. The fertility tests include:
Home urine LH testing
Basal body temperature charting (BBT chart)
Semen Analysis — It is estimated that about 40% of all infertility is attributable to a problem with the male partner. The semen analysis, therefore, is an essential step in the infertility evaluation. The sample should, ideally, be collected by masturbation. You should avoid using any lubricants. If you are unable to collect a sample by masturbation, please let your doctor or nurse know. We can provide a special Silicone condom that you may use with intercourse. Abstain from intercourse for 48 hours prior to collecting your semen sample, but do not abstain for longer than a week.
It is important that the semen sample arrive to the laboratory within 45 minutes after collection. Keep it warm, but do not overheat the sample. Our laboratory accepts samples for semen analysis between 8:00 am and 12:00 noon and 1:00 pm and 3:30 pm, Monday through Friday. We do have a private room for sample collection in our office. If it is more convenient for you, we will be happy to assist you in scheduling this test at a laboratory near your hometown.
Hormone Levels — Hormone evaluation is particularly useful in evaluating ovarian function. These tests are performed by obtaining a blood sample. Most of the tests are performed in our laboratory, so the results will be available within a couple of days. Since the levels may vary greatly at certain times in the menstrual cycle, the tests may need to be performed on a particular day of the menstrual cycle. The following are some of the tests that doctors may order for you based on your history:
Androgen levels: Androgens, often referred to as “male hormones,” are normally produced in women by the ovaries and adrenal glands. However, some women produce high levels of androgens that result in ovulatory dysfunction. Some of the androgen levels that may be ordered for you include testosterone, 17-hydroxyprogesterone (17-OHP), and dihydroepiandrosterone sulfate (DHEA-S) levels. In general, these tests may be performed at any time in the menstrual cycle.
Various:Follicle stimulating hormone (FSH), Luteinizing Hormone (LH), and Estradiol (E2) levels are generally low in the very early part of the menstrual cycle of women with normal ovarian reserve. However, in women with diminished ovarian reserve (peri-menopause or menopause), these levels may be elevated. Most patients are instructed to have these tests performed to evaluate their ovarian reserve. Day 3 labs may actually be performed on day 2, 3 or 4 of the menstrual cycle.
Estradiol levels (E2):As a follicle grows and develops, it produces increasing amounts of estradiol. Patients with normal ovulation or those who respond well to clomiphene citrate, estradiol monitoring has not be shown to be beneficial. However, for patients who require high doses of clomiphene citrate or gonadotropins for infertility treatment do benefit from estradiol monitoring. In general, this test is performed in conjunction with transvaginal ultrasound prior to ovulation.
Progesterone levels (P4):Progesterone is produced by the remnants of the follicle after ovulation, called the corpus luteum. Ovulation can be confirmed if the progesterone level reaches a specific threshold a week after ovulation. This test is recommended for patients who require no medications or clomiphene citrate to stimulate ovulation, and is performed eight days after the LH surge.
If you are in need of Houston fertility tests, please give us a call.