Before treatment for infertility can begin, the cause of the problem must be identified. There are numerous conditions and factors that can interfere with conception and it is not uncommon for a couple to experience more than one type of infertility. That is why we thoroughly screen each couple at our Illinois practice. Testing for infertility problems helps us to determine what treatments will be most effective for each patient.
A semen analysis is a simple and non-invasive test that can provide a wealth of information about the quality, quantity, and viability of sperm. A sample is collected by means of masturbation into a sterile specimen container. The sample is delivered to our laboratory, where it will be examined and evaluated for volume, concentration of sperm, motility (sperm movement), morphology (sperm shape), pH, and the presence of fructose. The results can indicate specific infertility problems or give us useful information with which to continue our assessment.
The “strict morphology” of the sperm (Kruger test) predicts a man’s fertility potential (fertilizing capacity), even in cases where the sperm count, motility, and/or regular morphology of the semen analysis are normal.
On cycle day 2, 3 or 4 of a period, we can assess a woman's ovarian reserve of eggs by measuring a blood test for Estrogen and FSH (Follicle Stimulating Hormone) and an ultrasound (US) of the ovaries. Ovarian reserve is based on the fact that the Pituitary gland in the brain, by making FSH (Follicle Stimulating Hormone), controls the ovarian hormone production (Estrogen/Progesterone) and the development of the eggs including ovulation (release) by a mechanism of negative feedback.
If the woman's Pituitary gland senses on day 2, 3 or 4 that there are not many egg sacs (follicles) present that month, it responds by over-producing higher levels of FSH hormone in order to stimulate the stubborn ovaries to try to make eggs and produce Estrogen. High levels of FSH (over 15) are a bad sign, indicating that she may have fewer eggs left with diminished quality.
Another method we use is an ultrasound to measure the number of follicles we count in each ovary on day 2, 3 or 4, known as Antral Follicle Count. Just like FSH levels, this follicle count varies with a woman's age. We always want to see at least five or more tiny follicles per ovary, and the more we find, the better.
Blood tests of anti Mullerian hormone and/or Inhibin are other measures of ovarian reserve.
A simple test that is known as a clomiphene citrate challenge test (CCCT) may be administered to measure a woman's ovarian reserve. First, a blood test will be taken on day three of the menstrual cycle. From day five through day nine, the patient will take a daily dose of clomiphene citrate, a common fertility medication. On day ten, another blood test will be performed. The levels of estrogen and follicle stimulating hormone (FSH) detected by these two blood tests will indicate the adequacy of the patient's egg supply.
For more information, please read Dr. Jacobs' article - "Ovarian Reserve Explained" (PDF)
The body's endocrine system is responsible for controlling the timing and execution of each stage of the reproductive process. When hormones are out of balance, one or more of these stages can be interrupted, preventing pregnancy from occurring or being maintained.
In order to screen for hormone-related infertility problems in women, we administer blood tests and measure the levels of several hormones, including estrogen, progesterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone and other androgens, thyroid stimulating hormone (TSH), and/or prolactin. Because each of these hormones is released at a different time and at varying levels during a cycle and some of them can only be analyzed over time, accurate assessment of the problem may require a series of tests.
In males, infertility problems that are the result of a hormonal imbalance are less common. However, a hormonal workup is often performed when the results of a semen analysis or other examination indicate that further investigation is needed. These blood tests can be administered at any time and are used to evaluate levels of testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), and other hormones.
Some infertility problems are the result of blockage that prevents the sperm and egg from coming together or a malformation that prevents the reproductive system from working properly. These problems can exist in either the male or female and are detected during a physical examination and/or ultrasound. In many cases, these problems can be treated surgically or through assisted reproductive technology.
A safe and time-tested procedure, ultrasound is one physical examination method that uses very high-frequency sound waves to provide a visual image of the body’s internal structures. Ultrasound is commonly used during pregnancy to monitor the baby’s development or during ovulation induction to observe and count ovarian follicles. For testing purposes, we use it to identify infertility problems that cannot be detected through an external examination, such as uterine fibroids, ovarian cysts, a blockage of the ejaculatory duct, or testicular cancer.
A saline sonogram may be performed to evaluate the uterine cavity and the fallopian tubes. The saline sonogram is very useful for identifying uterine polyps, fibroids in or near the cavity, as well as adhesions.
A hysterosalpingogram (HSG) is an X-ray procedure that involves the introduction of iodine-containing dye into the uterine cavity. When the X-ray is used, the dye reveals the size, shape, position, and symmetry of the uterus. Abnormalities in uterine contour can indicate infertility problems such as fibroids, polyps, scar tissue, and congenital uterine abnormalities, such as a septum. The dye is also observed as it moves outward into the fallopian tubes. If anything prevents the dye from reaching the fimbriated ends of the tubes and dispersing, it may indicate a blockage in the tube that can obstruct eggs from migrating into the uterus.
Contact our offices, serving all of Illinois, to learn more about infertility problems and how they are diagnosed and treated.
Contact our offices in Illinois if you are experiencing infertility problems and would like to schedule a consultation.
Buffalo Grove
135 N. Arlington Heights Rd., Suite 195
Buffalo Grove, Illinois 60089
Phone: 847.215.8899
Fax: 847.215.8996
Consultation Office Hours:
Monday through Friday 7:00 am to 6:00 pm
Saturday morning - 9:00 am to 12:00 pm
Crystal Lake
5911 Northwest Highway, Suite 105
Crystal Lake, Illinois 60014
Phone: 815.356.7034
Fax: 815.356.7064
Consultation Office Hours:
Monday through Friday 7:00am to 6:00 pm
Wednesday evening hours to 8:00 pm
Sundays 9:00 am to 12:00 pm
Glenview
3703 W. Lake Ave., Suite 106
Glenview, Illinois 60026
Phone: 847.998.8200
Fax: 847.998.6880
Office Hours:
Monday through Friday 7:00 am to 5:00 pm