Fertility Testing
At Sanford Health, we offer a number of fertility testing options. Below is a list of male and female fertility tests that may be options for you and your partner.
Endometrial biopsy – This fertility test is used to determine if the lining of the uterus (endometrium) is developing normally. The providers will biopsy the uterine lining and send the sample to the lab to be tested. This is an outpatient procedure that usually takes less than five minutes. A blood pregnancy test will have to be performed before the procedure can be done (up to one week prior).
HSG - A hysterosalpingogram (HSG) is a female fertility test where an X-ray procedure is used to determine whether the fallopian tubes are open and to see if the shape of the uterine cavity is normal. An HSG is an outpatient procedure that usually takes 15 to 30 minutes. It can be scheduled days six to 10 of a cycle. A blood pregnancy test will have to be performed before the procedure can be done (up to one week prior).
Hystereoscopy - A hysteroscopy is a female fertility test that allows a doctor look at the lining of your uterus and see what problems might be preventing you from becoming pregnant. It can also be used to remove growths in the uterus such as fibroids or polyps. To see into the uterus, the doctor puts a tiny tool called a hysteroscope into your vagina and into the uterus. It has a light and camera hooked to it so the doctor can see the lining on a video screen.
Saline sonogram – A Hysterosonogram, or saline sonogram, is an ultrasound procedure using sterile saline to inflate the uterus to detect abnormalities of the uterus and endometrial (uterine lining) cavity. A saline sonogram is an outpatient procedure that usually takes five to 10 minutes. It can be scheduled days six to 10 of a cycle. A blood pregnancy test will have to be performed before the procedure can be done (up to one week prior).
Semen analysis (SA) – This male infertility test helps measure: sperm count (concentration) volume, pH, viscosity (ability to adhere), morphology (appearance), motility (amount of moving sperm), progression (forward motion), and other characteristics including agglutination (clumping together), and the presence of white blood cells or immature sperm. Men coming in to give a sample need to have a driver’s license to verify identification.
Trans-vaginal ultrasound – This fertility test is used to look at a woman’s reproductive organs. It involves a probe being inserted into the vagina. Like with any ultrasound, the probe sends out sound waves that reflect off anatomy and produces a picture.
Lab work and testing during fertility treatment
Below is a list of commonly ordered lab work during fertility care. Please note that during care, your values may not fall under the typical “normal” values for any given test. Your physician or nursing team will contact you with your results and whether or not the value is normal for you and your cycle.
Anti-mullerian hormone (AMH): a hormone that measures ovarian reserves. This test provides a general idea of the women’s “remaining egg supply”.
Counsyl testing: a comprehensive genetic test for +100 genetic diseases. Your DNA is analyzed and your risks are generated in a report for review. Genetic counselors are available through Sanford or Counsyl to give a detailed review of the risks found.
Estradiol (E2): an estrogen hormone produced by the ovaries. When undergoing ovarian stimulation, the results of the estradiol blood test and ultrasound provide your physician with information regarding the maturity of the oocytes (eggs). Your provider uses this test to help with dosing of medication.
Follicle stimulating hormone (FSH): a pituitary hormone that stimulates egg maturation in the ovaries and helps to evaluate ovarian function at baseline. High levels may suggest premature ovarian failure.
Human chorionic gonadotropin (HCG): (the pregnancy hormone) a hormone level that is the most specific measurement to detect early pregnancy. Levels are positive when greater than five.
Luteinizing hormone (LH): a hormone that is measured in conjunction with FSH in order to determine ovarian function or reserve. It also predicts in advance when ovulation is occurring.
Prenatal labs: ABO, Rh, Rubella, CBC and can include varicella. These labs are done to prepare for pregnancy and birth.
Progesterone (P4): hormone produced by the ovaries sometimes measured in order to determine whether ovulation has occurred. It functions to prepare the uterine lining for possible implantation of a fertilized egg.
Prolactin: a pituitary hormone that, if elevated, could cause a milky discharge from the breast, cessation of menstrual periods and infertility.
Testosterone: hormone secreted by the adrenal glands and mostly the ovaries. It can detect adrenal or ovarian tumors and at elevated levels is associated with female masculinity and polycystic ovaries.
Thyroid stimulating hormone (TSH): hormone used to evaluate thyroid function and/or evaluate progress of thyroid replacement therapy (synthroid). This will be increased when thyroid is underactive, decreased when over active.
Infectious disease testing: (same for men and women) Hepatitis B and C, HIV, RPR. Testing should be done yearly if participating in IUIs, IVF or frozen embryo cycles. The results will be either positive or negative depending on exposure.