Tests
Many diagnostic tests are available to evaluate human reproduction. Some of these tests provide important information when they are interpreted correctly. Other tests, however, have been rushed to market before they have been rigorously studied.
When a test is ordered it is important for you to understand why each test is being done and how the results may direct your care. And if your physician takes the time to understand your individual situation (values, finances, time constraints, etc.), he or she will be better equipped to decide what tests will provide the most useful information.
For example, there are several tests that provide information about the anatomy of the uterus. The HSG is not the best test for evaluating the uterus but it is very useful in providing information about both the uterus and the fallopian tubes. A saline sonohysterogram provides more information about the anatomy of the uterus but it is not a good test to look at the fallopian tubes.
Therefore, your individual circumstances may dictate which test is better at any given time. You should be an active and informed participant in all aspects of your care.
The basic evaluation frequently includes the following:
- History
- Physical examination
- Semen analysis
- HSG
- Hormonal evaluation
- Luteal phase progesterone
- Urine LH
- Thyroid testing
You may think that it is redundant for your fertility specialist to repeat certain aspects of the evaluation. For example, if you recently had a Pap smear, you may wonder why your fertility doctor would want to do another physical examination. The answer is that the same physical finding may mean something very different in the context of fertility.
A more detailed evaluation may include the following:
- Semen profile
- Pelvic ultrasound
- Laparoscopy/hysteroscopy
- Follicle-stimulating hormone (FSH) test
- Luteinizing hormone test
- Androgen test
- Prolactin test
The physical exam allows your physician to look for problems such as an enlarged thyroid gland, galactorrhea, abdominal and pelvic masses, and sometimes evidence of endometriosis.
