Fertility Evaluation at NYU Langone Reproductive Specialists of New York
Intervention recommendations vary by age. We suggest a fertility evaluation for women who are 35 or younger and are not pregnant after 1 year of unprotected sex. A woman between 36 and 39 years should try for 3 to 6 months. A woman who is 40 or older should seek treatment as soon as she decides to become pregnant.
Egg Check Test
As a woman ages, the number of eggs she has declines, and the eggs that remain lose their ability to stay fertile and sustain a pregnancy. This progression, called age-related infertility, starts at around age 35. Fertility declines until menopause, when the ovaries stop releasing eggs.
During an egg check test, we determine your ovarian reserve, or how many eggs you have and their quality. If the quality, quantity, or both are of concern, infertility treatments can help achieve a healthy pregnancy.
Using blood tests, we determine whether your hormone levels are affecting your ability to ovulate or maintain a pregnancy. We also evaluate you for thyroid or prolactin disorders, which can also affect fertility.
Luteal Phase Deficiency Testing
The luteal phase occurs after ovulation when the uterus starts to grow a lining in preparation for a fertilized egg. If that lining does not grow properly, the uterus is unable to sustain a pregnancy. This can lead to infertility or recurrent miscarriage. Luteal phase deficiency testing, which is performed with a blood test and uterine ultrasound, is used to determine the state of your uterine lining after ovulation. Treatment can include hormones that help the uterine lining to form.
Normal ovulation occurs roughly two weeks before your next expected period. Understanding whether you are ovulating regularly is vital to understanding your fertility issues. Your doctor uses hormone-detecting blood tests, ovarian ultrasound exams, or an at-home ovulation test kit to determine your ovulation patterns. If you are not ovulating regularly, your doctor may prescribe medications to stimulate egg production.
Tubal Patency Examination
Because fertilization occurs in the fallopian tubes, a blockage or scarring can make it difficult for sperm to reach the egg. Tubal patency examination allows us to examine the reproductive system. We perform a test called a hysterosalpingography, which combines an X-ray with radiographic dye, to visualize the fallopian tubes and uterus. Treatment can include surgery to open the tubes.
Uterine Abnormalities Examination
Using ultrasound testing, we examine your reproductive system to look for issues that might be causing infertility, such as fibroids, polyps, adhesions, and congenital abnormalities.
Male Factor Infertility Testing
To determine male factor infertility, your doctor takes a medical history and performs a physical examination, semen analysis, sperm morphology, hormone testing, and other procedures. A semen analysis determines sperm motility (activity) and sperm concentration (amount). Sperm morphology, which evaluates of the shape of the sperm, is also performed. This helps doctors figure out whether or not the sperm can penetrate and fertilize eggs with in vitro fertilization (IVF).
If you or your partner has a family history of a genetic disorder, it is best to talk to your doctor and be screened before you become pregnant. This can help you understand your risk of passing the condition on to your child. If you are a carrier, preimplantation genetic screening can be used with IVF to reduce the risk of your baby carrying the gene. During pregnancy, amniocentesis or chorionic villus sampling (CVS) testing can be done to screen for inherited conditions.