Before you begin IVF you will go through a screening process to assess your reproductive health. This process may take 2-3 weeks. During your telephone consultation or office visit, you will meet your physician, a reproductive endocrinologist (RE), who will take a detailed history and explain the process of in vitro fertilization and embryo transfer. Your doctor will order various tests and arrange a visit or telephone consult with the nurse coordinator and financial counselor. Testing might include:

Cycle day 3 blood tests:

A blood sample is drawn on the third day of your menstrual cycle (cycle day 3) to test your pituitary gland, ovaries, blood type, and certain infectious diseases (such as hepatitis and HIV). The results of these tests will help us plan your stimulation protocol and general medical care. Your doctor may select other screening tests according to your medical and fertility history. Please ask if the reason for any test is unclear to you.

Mid-Cycle Ultrasound:

An ultrasound is performed near the time of ovulation to measure the endometrium, which is the inside lining of the uterus, the location of early embryo development. The uterus, cervical canal, and ovaries are also studied. Critical measurements include the thickness and pattern of the endometrial lining, the curvature of the cervical canal, and the position of the uterus. A catheter may be passed through the cervix to measure the depth of the uterus, a uterine measurement or mock embryo transfer. A brief physical exam may also be performed if this is the first time you meet your doctor.

Hysterosalpingogram (HSG), Hysteroscopy or Hysterosonogram:

Hysterosalpingogram is a test done in the radiology department of the hospital to test your fallopian tubes and the uterus. This test is a frequently performed fertility test, but is not required prior to IVF. A small amount of fluid is injected into the uterus and tubes and an X-ray picture is taken. The picture outlines the uterine cavity and fallopian tubes and provides important information about the inside of your uterus.

Hysteroscopy is an examination of the interior of the uterus performed using a narrow hysteroscope, a long thin telescope with a light and lens. Small lesions like polyps and fibroids could prevent attachment of an embryo and act like an IUD inside your uterus. These can be removed through the hysteroscope.

Hysterosonogram (Saline Sonogram): A hysterosonogram is another test which can be performed to evaluate the uterine cavity for polyps or fibroids. A small amount of fluid (sterile saline) is injected through a catheter placed through the cervix and into the uterine cavity while a vaginal ultrasound is performed at the same time. This provides important information about the inside of your uterus without surgery or exposure to x-rays.

Semen analysis:

A semen analysis provides a measure of semen volume, sperm concentration or number, sperm motility and sperm morphology. Although we accept evidence of normal sperm counts from outside laboratories, if there is any history of sperm abnormalities, we may request a semen analysis be performed in our laboratory before the planned IVF cycle. If persistent abnormalities are detected, a more detailed evaluation including additional tests and/or an exam by a urologist may be suggested. Fortunately, with the availability of ICSI (Intracytoplasmic sperm injection) we now have a very effective method of producing pregnancies even when sperm function is very poor.

Infectious Disease Tests:

California state law requires testing of all male partners in IVF treatment for agents of viral hepatitis (B and C), HTLV-I, syphilis, and HIV I and II. State law also requires us to screen female partners for the same diseases before their embryos are frozen. These are legal requirements which cannot be waived.