Assessing your Fertility
During your first appointment, your physician will want to complement your existing medical history with some further examinations to uncover insights on your fertility health. This may require that you and your family group have certain tests, which will enable the physician to offer you individualized treatment options.
You would both meet with a physician who performs routine physical exams.
Blood samples are taken to measure the different hormone levels prior to any treatment. Endocrine testing can also be used in cases of anovulation or when anomalies have been detected through the semen analysis.
Blood samples are taken to analyze blood type and to look for syphilis, Hepatitis A, B and C and the HIV (AIDS) viruses and immunization against rubella among others.
Ultrasounds, both abdominal (external) and a transvaginal (internal) ultrasound, are used to assess the ongoing development of follicles (egg sacs) within the ovary.
A sample of mucus is taken from the cervix and examined under the microscope for assessment of characteristic cycle changes. This test is performed in a similar manner to a pap smear.
An evaluation of the sperms' survival in pre-ovulatory cervical mucus. Intercourse must take place the night before or the morning of the scheduled office visit, after a short period of abstinence.
A hysterosalpingogram is an examination where a dye is injected through the cervix to visualize any blockage of the fallopian tubes and the shape of the uterine cavity.
In this test, sterile saline is passed through the cervix into the uterus and visualized by transvaginal ultrasound to assess the uterine lining, shape and texture, and fallopian tubes.
If a blockage in a fallopian tube is found through the HSG test, in some instances, the tube can be opened by inserting a brush-like instrument and catheter into the fallopian tube.
Day surgery which consists of two to three small incisions in the abdomen. One is generally made in the navel and the others in the right and left lower quadrants. A laparoscope (camera/telescope) is introduced into one of the incisions and is used to look at your reproductive organs (uterus, fallopian tubes, etc.,) as well as to detect possible endometriosis.
The uterine cavity is visualized to look for tumors, adhesions or other abnormalities. If needed, this procedure can be done at the same time as the laparoscopy and the hysterosalpingogram test.
Sperm Wash Assessment
Analysis of a freshly ejaculated sperm sample done under the microscope or assisted by computer (CASA), to examine sperm motility, morphology and viability. Other tests may include Strict Sperm Morphology, Anti-Sperm Antibody (MAR), Vital Staining, and Endtz’s Test for the detection of white blood cells in semen. Depending on these findings we may assess certain sub-components of the sperm that may need more advanced tests such as molecular biology techniques or electron microscopy.
Sperm DNA Damage
We test Sperm Chromatin Structure Assay (SCSA®) to assess sperm DNA Damage. DNA fragmentation in sperm may be the result of many factors including disease, diet, drug use, high fever, elevated testicular temperature, air pollution, cigarette smoking and advanced age.
Vasectomy is one of the common methods for male contraception. Nevertheless, spermatozoa tend to persist in seminal fluid for variable durations following the vasectomy procedure. That is the reason why most physicians advise patients to use an alternative method of contraception for a few weeks following the operation. A post-vasectomy screen is available for those patients who have recently had a vasectomy. This method provides assurance regarding the results of the procedure.
Sperm Binding Assay
Testing hyaluronan binding assay (HBA) is a way to determine the maturity of sperm in a fresh semen sample and its ability to bind to the external coating of female eggs. The test helps identify candidates for intracytoplasmic sperm injection (ICSI), an advanced assisted reproductive technique.
A biopsy of the testicles in patients where no sperm could be found in the ejaculate can indicate if there is an obstructive lesion that can be corrected by surgery. It can also provide critical information in demonstrating whether normal sperm are being created.