After your initial consultation with a physician, an individualized, diagnostic plan will be outlined to determine the cause of your infertility. This plan is based on the information provided by your medical history and physical examination.

Once your diagnosis is established, a treatment plan will be tailored to suit your personal situation. The recommended approach will depend on your age, diagnosis, the duration of infertility, any previous treatments, and your personal preferences.

This section allows you to search our diagnosis and treatment database by topic or you may click browse topics for a complete table of contents.

The tests performed to diagnose infertility are typically referred to as pre-screening tests. Before you initiate a treatment cycle, it is critical for your physician to identify any potential obstacles to achieving a pregnancy. This assessment is determined by the results of the male and female pre-screening tests. Testing is individualized, every test is not performed on every person.

Female:

Ovarian Function Tests

An essential aspect of all treatment cycles is the ability to recruit and, in the case of IVF, retrieve one or more eggs. A variety of drug regimens can be used to achieve this goal. This plan is based on the level of ovarian function. Ovarian function is determined by evaluating several hormone levels on day 3 of the menstrual cycle:

• FSH (follicle stimulating hormone)
• LH (luteinizing hormone)
• E2 (estradiol)

Depending on the diagnosis, we may need to take a closer look at your ovarian function using a Clomiphene Citrate Challenge Test. To perform this test, your FSH level is measured on Day 3 of your cycle. Clomiphene Citrate is taken by mouth on Days 5-9 and another FSH level is measured on Day 10. The results give us an insight to how your ovaries might respond to medications during the actual cycle. Transvaginal ultrasound exam viewing the uterine and ovarian anatomy, including a count of small resting (antral) follicles also helps evaluate reproduction.

Embryos implant in the uterus, therefore, we may perform tests to determine if the uterine cavity is normal. This is evaluated by a hysterosalpingogram or a hysteroscopy. These tests are scheduled between the end of menses and the onset of ovulation.

• HSG — X-Ray’s the flow of dye through the uterus and the tubes.HSG's can be performed in our Rockville and Towson offices or in any other radiology center or hospital.

• Hysteroscopy — viewing of the uterine cavity through a lighted scope.
• Sonogram/Fluid Sonogram — view of the uterine wall or cavity by ultrasound.

Hepatitis B surface antigen; Hepatitis C antibody; HIV; RPR (serology); Rubella titer (one time only); Blood group and RH (one time only). Negative infectious disease result must be documented every twelve months.

Male:

Infectious Disease Testing
HIV; Hepatitis B surface antigen; Hepatitis C antibody; RPR (serology).

A semen analysis is a test that tells your doctor the number of sperm in your semen, whether they are normal, and how well they move.
Male fertility and sperm healthThere are many reasons why couples have trouble achieving pregnancy. A semen analysis is one of the tests your doctor will use to evaluate your problem. Your test results will tell your doctor the number of sperm in your semen (your sperm count), whether they are normal (morphology), and how well they swim (motility). A low sperm count may be caused by certain medications or a medical problem such as a blocked duct, low testosterone level, or a condition in which sperm back up into the bladder. Fever can also reduce sperm count. Some men may have enough sperm, but their sperm may not swim well enough to reach the egg. Also, sperm that are not normal in shape may not be able to penetrate and fertilize the egg. Your doctor can treat many of these problems.

Your doctor will want you to provide a semen sample. The sample is collected by masturbation at your doctor’s office in a private, comfortable room. You will be asked to collect your semen in a sterile specimen cup. Another option is to collect your semen at home by masturbation or during intercourse in a special condom that you can get from your doctor. You must deliver your sample to the doctor’s office within 45 to 60 minutes after collecting it. Speak with your doctor about instructions for transporting the sample to the office. If the results are not normal or the sample is not complete because you missed the container for sperm collection, this test may need to be repeated. Test results often vary, so you may need to do this procedure more than once.