Egg – oocyte Quality and Quantity
Your eggs are evaluated in a couple of different ways. One of the first items that is looked at is your overall ovarian reserve. No one can tell you for sure exactly how many eggs you have left, but by looking at a few blood tests and a vaginal ultrasound, we can get an idea of what your fertility potential is with respect to your eggs. Some of these tests should be done on Day 3 of your period including a vaginal ultrasound to look at your antral follicle count (looking at the number of eggs that could potentially be produced that month) and a Follicle Stimulating Hormone (FSH) level, which is a blood test that helps look at the quality and quantity of your eggs.
Another blood test that is done is called the Anti-Mullerian Hormone level or AMH. Each one of your eggs puts off anti-mullerian hormone and so the level of your AMH tells us about what your reserve is. Most labs take two weeks to process this result, but Generation Next has a machine that can tell you the result the same day, getting you on your way to fertility success!
A semen analysis is best performed after abstaining from ejaculation for 2-5 days. Longer than 5 days may not yield as fresh and accurate of a sample. An analysis of the sperm tells us a few things about it. It tells us the volume of the ejaculate, the count, or concentration of the sperm in the sample, the motility or how many of the sperm are actively moving, and finally the morphology which is a reference to how many sperm look to have a normal shape to them. Male factor infertility could be due to a low count of sperm, a low motility rate (low number of sperm that are moving), or a low morphology (low number of normal appearing sperm). If your partner is experiencing erectile dysfunction or a low sex drive he should be evaluated, but unfortunately male factor infertility often shows no signs. There are options for treatment though! There are treatments options both for him individually (some as simple as oral supplements), and reproductive treatments to help with getting pregnant.
Uterus: Saline Infusion Sonohysterogram or Hysteroscopy
In order to take a look at your uterine cavity more specifically, we may recommend a Saline Infusion Sonohysterogram (SIS) or Hysterosonogram (HSN). They are both terms for inserting simple saline into the uterus while using a vaginal ultrasound probe to evaluate the shape of the uterine cavity and to look for polyps. If something is found, or if you have been unsuccessful with IVF, the doctors at Generation Next may recommend a procedure called a Hysteroscopy. This is a procedure that is done under IV sedation, where a very small camera is inserted into the uterus to evaluate it further. A biopsy is usually also done to make sure that there are no other issues such as infection, inflammation, or abnormal tissue growth that cannot be seen by the camera visually.
Fallopian Tubes: Hysterosalingogram and Tubal Patency
A hysterosalpingogram or HSG test is a procedure where they insert dye into your uterus to evaluate your fallopian tubes to make sure they are open to receive the sperm and meet the egg. It also takes a basic look at your uterine cavity to see that it is not misshapen due to fibroids or there are no protrusions such as polyps (an overgrowth of tissue protruding into the cavity).