Fertility Testing & Diagnostics
AMH / Cycle Day 2-4 FSH / E2 Testing
Anti-Müllerian Hormone (AMH) and Cycle Day 2-4 Follicle-Stimulating Hormone (FSH) and Estradiol (E2) testing are critical assessments in evaluating a woman’s ovarian reserve and reproductive potential. AMH levels provide an estimate of the remaining egg supply, helping to predict how the ovaries might respond to fertility treatments like IVF. Testing FSH and estradiol levels on cycle days 2-4 gives insight into the function of the ovaries and the hypothalamic-pituitary-ovarian axis. Elevated FSH levels can indicate reduced ovarian reserve or potential fertility issues, while estradiol levels help in interpreting the FSH results, providing a more comprehensive picture of reproductive health. These tests are essential for tailoring fertility treatment plans to maximize the chances of a successful pregnancy
Ultrasound follicle count testing, also known as an antral follicle count (AFC), is a key part of fertility evaluation. During this test, a doctor uses an ultrasound to count the small fluid-filled sacs, called follicles, in a woman’s ovaries. Each follicle contains an immature egg, and the number of follicles helps assess a woman’s ovarian reserve—essentially, how many eggs she has left. A higher follicle count usually indicates a better chance of success with fertility treatments like IVF, while a lower count may suggest a reduced ovarian reserve. This test provides important information for creating a personalized fertility treatment plan.
Ultrasound Follicle Count Testing
HSG Test
Hysterosalpingography (HSG) is a specialized X-ray test used to evaluate the health of a woman’s fallopian tubes and uterus (less sensitive with regards to uterine evaluation), which are critical for natural conception. During the test, a special dye (iodine-based) is gently injected into the uterus through the cervix, and X-rays are taken to see if the dye flows freely through the fallopian tubes. This helps doctors identify blockages, scarring, or other abnormalities that could be preventing pregnancy. Dr. Nastaran Foyouzi’s extensive experience in reproductive medicine allows her to expertly interpret the results of an HSG test, understanding how any detected issues might interact with other fertility factors. Her background in reproductive genetics also means she can look at the big picture, integrating HSG findings with genetic considerations to create a well-rounded and effective fertility treatment plan.
A saline sonogram, also known as a saline infusion sonohysterography (SIS), is a special ultrasound test used to check the inside of the uterus for any abnormalities, such as polyps, fibroids, or scar tissue. During the procedure, a small amount of sterile saline (salt water) is gently injected into the uterus through a thin tube. The saline expands the uterus slightly, making it easier for the doctor to see its lining and detect any issues on the ultrasound.
When a tubal patency evaluation is added, the test also checks whether the fallopian tubes are open or blocked. In this case, a special contrast fluid (Mixed normal saline with a bubble of air) is used instead of just saline, which helps the doctor see the flow the bubble of air through the fallopian tubes on the ultrasound. If the fluid passes through the tubes, it means they are open, which is important for natural conception. This procedure is quick, usually done in the office, and helps provide valuable information for diagnosing and treating fertility problems. It is more favored by many patients since it does not cause as much pain as an HSG.
Saline Sonogram
Semen Analysis
A semen analysis is a key test for evaluating male fertility, helping to identify potential issues that might affect a man’s ability to father a child. During this test, a sample of semen, which contains sperm, is collected, usually through masturbation, at a clinic, or sometimes at home. We usually recommend 1-3 days of abstinence before semen analysis. Since longer abstinence may result in a false result (Low motility). The sample is then examined under a microscope in a laboratory to assess several important factors: the number of sperm (sperm count), their movement (motility), their shape (morphology), and the volume and consistency of the semen itself. These parameters are crucial for understanding a man’s reproductive health. For example, a low sperm count, or poor motility could make it harder to achieve pregnancy naturally, while abnormalities in sperm shape might impact the ability to fertilize an egg. The results from a semen analysis guide doctors in diagnosing male infertility and determining the best course of treatment.
Sperm DNA fragmentation testing is a specialized test that checks the quality of sperm by analyzing the DNA inside each sperm cell. Even if a man’s sperm looks normal in terms of count, movement, and shape, the DNA inside can sometimes be damaged or “fragmented,” which can make it harder for the sperm to successfully fertilize an egg or can cause issues with embryo development, potentially leading to infertility or miscarriage. This test helps identify those hidden issues and guides doctors in choosing the best fertility treatment. Sperm DNA fragmentation testing is not indicated for every male fertility evaluation.
Dr. Nastaran Foyouzi’s expertise as a reproductive geneticist is crucial in this context. Her deep understanding of genetics allows her to interpret these complex results more accurately and tailor treatments to the specific needs of each patient. Her knowledge ensures that the most effective strategies are used to address any genetic concerns, improving the chances of a successful pregnancy.
Sperm DNA Fragmentation Testing
Diagnostic Hysteroscopy (Endosee)
Diagnostic hysteroscopy is a procedure that allows doctors to take a close look inside the uterus using a thin, lighted tube called a hysteroscope. This tube is gently inserted through the cervix into the uterus, giving the doctor a clear view of the uterine lining and the opening of the fallopian tubes. This procedure is very useful for diagnosing infertility, failure of implantation and uterine causes of recurrent pregnancy loss because it can detect abnormalities that might be missed with other tests, such as scar tissue that covers the uterine wall and con not be detected by saline sonogram, or other issues that could prevent pregnancy or cause miscarriages or even uterine thin lining. By identifying and sometimes even treating these problems during the same procedure, diagnostic hysteroscopy plays a vital role in helping doctors develop an effective fertility treatment plan. This procedure could be done safely and comfortably in the office and is considered a gold standard for diagnosing any uterine abnormalities.
An Embryo Test Transfer is a practice run before the actual Frozen Embryo Transfer (FET) procedure. Test transfer will map the route from the cervix to the uterine cavity so that on the day of actual embryo transfer there are no surprises. During this test, Dr. Foyouzi uses a thin, flexible tube, called a catheter, to gently guide it through the cervix and into the uterus, just as she would during the actual embryo transfer. This helps Dr. Foyouzi map out the best path and determine the right placement for the embryos when the real transfer takes place. By doing this test transfer beforehand, the doctor can ensure that everything goes smoothly during the actual FET, increasing the chances of a successful pregnancy.
Embryo Test Transfer before FET
Male & Female Hormonal Testing
Male and female hormonal testing is an essential part of diagnosing and treating infertility. For women, it involves checking levels of hormones like estrogen, progesterone, FSH, LH, and AMH to understand how well the ovaries are functioning, how eggs are maturing, and whether ovulation is happening regularly. For men, hormone tests usually focus on testosterone and other related hormones that influence sperm production. These tests help identify any hormonal imbalances that could be affecting fertility. For men, Hormonal testing usually will be ordered when semen analysis is abnormal or suboptimal. Dr. Foyouzi’s advanced training in reproductive genetics is particularly valuable here because she can connect these hormone levels with underlying genetic factors that might be impacting fertility. Her expertise allows her to tailor treatments more precisely, addressing both hormonal and genetic aspects to improve the chances of a successful pregnancy.