Initial Consultation: The First Step
Ideally both you and your partner should attend the initial consultation with Dr. Cardone. The doctor will take both of your medical histories. It is helpful to bring records of previous infertility workups and treatment to this meeting. Often, the doctor will perform a physical exam on the female partner, including a breast exam, vaginal culture, pap smear and pelvic exam. This exam should not take the place of a yearly physical with your primary care doctor.
The Fertility Evaluation Cycle
The doctor will order a series of evaluation tests. We try not to duplicate tests unnecessarily, especially if you have undergone previous infertility evaluations. The following tests will be ordered, depending on what the physician determines is needed based on the findings of the initial consultation:
Evaluation of the Male Infertility Patient
- Semen analysis and culture for the male partner
- HIV 1 & 2, Hepatitis B & C, and RPR (for venereal diseases)
Evaluation of the Female Infertility Patient
To determine if the female partner has problems concerning ovulation, egg transport, fertilization, or implantation, various tests may be administered based on Dr. Cardone’s examination and analysis. These may include:
• Serum hormone testing measures the levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin, progesterone, and thyroid stimulating hormone (TSH). FSH is produced by the anterior pituitary gland and stimulates the ovaries to develop follicles before ovulation. Progesterone hormone is produced after ovulation has occurred and prepares the lining of the uterus for pregnancy. Inadequate levels could interfere with the development of the endometrium. LH is secreted by the anterior lobe of the pituitary gland and increases in the middle of the cycle to induce the release of an egg.
• LH and FSH levels are checked for hypothalamic pituitary dysfunction.
• Also prolactin, a hormone stimulating breast milk, levels are analyzed to see if an excessive amount has caused hyperprolactinemia, a condition that interferes with ovulation.
• Ultrasounds are performed seven to nine days after ovulation to reveal the thickness of the uterine lining and its response to hormonal stimulation.
• Hysterosalpingogram (HSG) is an x-ray of the uterine cavity and fallopian tubes using a radiographic dye to detect structural abnormalities.
• Laparoscopy is a minimally invasive surgical procedure that permits direct visual assessment of the uterus, fallopian tubes, ovaries and lower pelvis. It is particularly useful in diagnosing endometriosis, tubal disorders, or pelvic adhesions.
• Hysteroscopy often is done in conjunction with a laparoscopy to visually examine the interior of the uterine cavity for scar tissue, adhesions, polyps, tumors and other abnormalities and to eliminate endometriosis.
• An endometrial biopsy takes a tiny tissue sample from the endometrium, the lining of the uterus, to determine if it has responded appropriately for implantation of the embryo to occur.
Read the evaluation cycle instructions.