Fertility Testing 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 before considering testing. A woman who is 40 or older should seek treatment as soon as she decides to become pregnant.
For people with certain medical conditions that can affect fertility, we recommend evaluation as soon as you decide to become pregnant. We provide diagnosis and gynecologic care for these conditions, which include primary amenorrhea, Müllerian anomalies, endometriosis, and hormone imbalances caused by conditions such as polycystic ovary syndrome. We also discuss any lifestyle habits that may affect fertility, and can assess a male partner’s fertility.
Fertility Testing for Women
The following tests and exams are used to determine fertility in women.
We use blood tests to 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. There can be several reasons for recurrent miscarriage, and a full evaluation that includes luteal phase deficiency testing can help reduce the risk of future pregnancy loss.
Luteal phase deficiency testing, which is performed with a blood test, uterine ultrasound, endometrial biopsy, or a combination of these, determines whether the uterine lining is able to sustain a pregnancy. If deficiencies are detected, hormone therapy can help stabilize the uterine lining and prepare it for implantation of the fertilized egg.
Ovarian Reserve Fertility Testing
As a woman ages, the number of eggs she has declines, and the eggs that remain lose their ability to sustain a pregnancy. This progression, called age-related infertility, starts at around age 35. Fertility declines until menopause, when the ovaries stop releasing eggs.
Ovarian reserve fertility testing, also known as an egg check test, can help determine how many eggs you have in the ovaries, and their likelihood of resulting in pregnancy. This test has two parts: a blood test and a pelvic ultrasound. The blood test evaluates hormone levels that correlate with the quantity of eggs still in the ovarian follicles, and the ultrasound helps your doctor to see how many follicles remain in reserve. If the quality, quantity, or both are of concern, infertility treatments can help achieve a healthy pregnancy. This test can also be used to help you determine whether fertility preservation through egg freezing is the right choice for you.
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 in the tubes can make it difficult for sperm to reach the egg. Tubal patency examination uses one of two tests to visualize the fallopian tubes and uterus. Hysterosalpingography combines an X-ray with radiographic dye to create an image that allows your doctor to diagnose any blockages. Saline sonogram works in a similar manner, using saline solution and ultrasound imaging. Treatment includes surgery to open the fallopian tubes.
Uterine Abnormalities Examination
Using ultrasound testing, we examine your reproductive system to look for uterine abnormalities that might be causing infertility, such as fibroids, polyps, adhesions, and congenital abnormalities that affect the shape of the uterus. Endometrial biopsy may be used to examine the uterine lining for issues that prevent implantation or lead to recurrent miscarriage.
Fertility Testing for Men
To determine male factor infertility, your doctor takes a medical history and performs a 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 determine whether or not the sperm has the ability to penetrate and fertilize eggs during in vitro fertilization (IVF). We also provide a referral to a urologist for further evaluation of male infertility.