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| Diagnostic procedures |
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| The following tables contain the most common diagnostic procedures of your comprehensive evaluation to determine the underlying cause of your infertility. |
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| Basic Screening Preconceptional Panel |
| Female Testing |
Type of Test |
Expires |
| HIV |
Blood Test |
after 1 year |
| Hepatitis panel |
Blood Test |
after 1 year |
| VDRL or RPR |
Blood Test |
after 1 year |
| Chlamydia |
Cervical Culture |
after 1 year |
| Gonorrhea |
Cervical Culture |
after 1 year |
| Pap Smear |
Cervical Sampling |
after 1 year |
| Cystic Fibrosis |
Blood Test |
Never |
| Rubella antibodies |
Blood Test |
Never |
| Varicella |
Blood Test |
Never |
| Blood group and Rh factor |
Blood Test |
Never |
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| Male Testing |
Type of Test |
Expires |
| HIV |
Blood Test |
after 1 year |
| Hepatitis panel |
Blood Test |
after 1 year |
| VDRL or RPR |
Blood Test |
after 1 year |
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| Comprehensive Fertility Work-up |
| Female Testing |
Indication |
Type of Test |
Factor Assessed |
| Hysterosalpingogram (HSG) |
Basic work-up |
X-Ray or Dye Test |
Tubal and Uterine Factor |
| Serum Progesterone |
Basic work-up |
Blood Test |
Ovulation |
| Ovulation Predictor Kit |
Basic work-up |
Urine |
Ovulation |
| Clomiphene Challenge Test |
Unexplained infertility, 30-40 years of age, one single ovary, poor response to ovulation induction |
Blood and Ultrasounds |
Ovulation (Ovarian Reserve) |
| Saline Ultrasound |
Recurrent miscarriages, IVF pre-testing |
Ultrasound |
Uterine Factor |
| Hysteroscopy |
Recurrent miscarriages, IVF pre-testing |
outpatient surgery |
Uterine Factor |
| Laparoscopy |
suspected endometriosis or adhesions |
outpatient surgery |
Tubal and Peritoneal Factor (i.e. endometriosis, scarring tissue) |
| Karyotype |
Recurrent miscarriages, premature ovarian failure, etc. |
Blood Test |
Chromosomes |
| Mammogram |
If > 40 years of age |
X-Ray or Dye Test |
Breast CA Screening |
| Uterine Catheter Trial Transfer |
IVF pre-testing |
Blood Test |
Never |
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| Male Testing |
Indication |
Type of Test |
Factor Assessed |
| Semen Analysis |
Basic work-up |
Semen sample |
Male Factor |
| Sperm Antibodies |
Basic work-up |
Semen sample |
Male Factor |
| Karyotype |
Recurrent miscarriages in partner, Very low sperm counts |
Blood Test |
Chromosomes |
| Y-Deletion |
Very low sperm counts |
Blood Test |
Male Factor |
| FSH, Testosterone, TSH, PRL |
Low sperm counts |
Blood Test |
Male factor |
| Post-ejaculatory urine analysis |
Very low sperm volume, suspicion of retrograde ejaculation |
Semen sample/Urine sample
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Male Factor |
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Preliminary Screening Test
For most couples, several tests will be required prior to initiating the IVF cycle. These are designed to look for problems that could have an adverse impact on your treatment or subsequent pregnancy. If you have had any of the tests listed below done, please make the results available to your Nurse. Depending upon the test, you may not need to have the test repeated immediately prior to your cycle. Because of the nature of some tests, we will ask that certain tests be done at RMATX or by a lab approved by our office. |
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| FEMALE TESTING |
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Blood Tests |
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FSH / LH / Estradiol |
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This combination of FSH (follicle stimulating hormone), LH (luteinizing hormone) and estradiol drawn on day 2, 3 or 4 of the cycle is a reflection of the female partner’s ovarian reserve, or how well we expect her ovaries to respond to stimulation. We will generally test all women regardless of age, because of the wide range of variation of the onset of menopause and ovarian function in infertility patients. These tests will help us determine which procedures and protocols are most appropriate. |
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Infectious Screen (chlamydia, hepatitis, syphilis, HIV, mycoplasma, gonorrhea) |
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Having one of these infections could adversely affect the outcome of your procedure or your pregnancy should you become pregnant. |
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Pregnancy Screen: (Blood type and Rh Factor, Rubella titer,complete blood count) |
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Determining Blood type can be helpful if there are problems with a pregnancy. Rubella is an infection that can cause serious birth defects if it occurs while you are pregnant. Most of us have been immunized against it. However, some people have not been immunized or their immunization is no longer working. This test determines if immunization is needed. A complete blood count screens for anemia and other blood disorders and can tip us off about certain inherited disorders. |
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Prolactin, TSH |
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These hormonal tests screen for subtle abnormalities that could effect your treatment or your pregnancy. Both hormones are made by the pituitary gland in the brain. Prolactin is a hormone that helps to stimulate milk production during breast-feeding. Some women will secrete too much prolactin when not breast-feeding.TSH (thyroid-stimulating hormone) is the most sensitive test of thyroid function. It can detect either over activity or under activity of the thyroid gland. |
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Anti-sperm Antibodies |
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Antibodies are proteins in the blood made by white blood cells. Their normal role is to help us fight off infections.Sometimes the immune system recognizes normal things (in this case sperm) as foreign and makes antibodies to attack them. The presence or absence of these antibodies will help us determine what procedures are appropriate for you. |
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Other testing |
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If your medical history, family history or testing suggests that you may be at risk for genetic or autoimmune diseases, or other medical problems, appropriate tests will be ordered prior to initiating the cycle. |
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Radiologic Evaluation |
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Trial Transfer |
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A special catheter is inserted into your uterus to determine the direction and length of the uterine cavity. This measurement may also be done by ultrasound. This is done so that when the actual embryo transfer is done, it will occur in the smoothest possible fashion |
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Pap smear |
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A screen for cervical cancer and human papilloma virus infections. Currently, screening for most women is to be done on a yearly basis.
NOTE: Some women may require more frequent mammogram and Pap smear testing, depending on their medical and family histories. |
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Genetic Questionnaire |
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Inherited or genetic disorders are a major cause of birth defects and miscarriages. Please contact your IVF Nurse if you have not completed the Family History and Genetic Questionnaire. |
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| MALE TESTING |
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Semen Analysis, Antisperm Antibodies and Cryopreservation |
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A Semen Analysis is requiredto determine if the male partner’s sperm is normal. If the sperm is compromised, ICSI may be necessary (intracytoplasmic sperm injection) to optimize fertilization. The presence or absence of sperm anti-sperm antibodies will help to determine what procedures are appropriate. Cryopreservation is a process whereby sperm is frozen to be used if there are any issues with producing a fresh specimen during your IVF cycle.
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Infectious Screening: (HIV, syphilis, hepatitis |
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With these diseases you may be infected, but asymptomatic for long periods of time. All of these can be passed along through the semen. There are, however, no reports of these ever being transmitted at IVF.
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Special Male Testing |
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Men with certain infertility problems may be asked to get any of the following tests.
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Karotype
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This is a test that evaluates the chromosomes. In some conditions, the rate of chromosomal abnormalities is increased. Finding a chromosomal abnormality would mean that the sperm of that individual would not be used. |
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Y-deletions testing |
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In some men with very low sperm counts, the problem is due to structural abnormalities in the segment of the Y-chromosome that sperm development. Pregnancy can occur (via IVF with ICSI), but these abnormalities can be passed on to any male children. |
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Cystic Fibrosis |
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Cystic fibrosis is a genetic disorder, which is characterized by excessively thick secretions form mucus glands. It is the most common lethal genetic disease in the Caucasian population. About 1 in 25 Caucasians carry the gene. However, in certain disorders that are associated with male infertility, the chances of carrying the abnormal gene are 1 in 4. If it were found that you carry the gene, then your wife would be tested. For our policy on routine genetic please see below. |
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