Infertility Testing: Tips & Tricks
Alternative title
Infertility Testing: The Things They Don’t Tell You
Hi Friends,
I am writing to you as someone who is going through infertility testing for a second time, and wishing I’d had some reminders myself for the procedures that aren’t routine for me.
Tests
Ovarian Reserve Testing - via Blood Test
Antral Follicle Count (AFC)
Anti-Mullerian Hormone (AMH)
Follicle Stimulating Hormone (FSH)
Day 3 Estradiol Level
Pre-Treatment Testing*
Genetic Carrier Screening - via Blood Test
A majority of this testing is done via blood work, simple labs run by your doctors office. This includes a cluster of tests done to review your ovarian reserve, and also the option of genetic carrier screening pre-treatment. These tests, along with the HSG and SIS listed above will help your doctor to determine the most beneficial treatment plan for you and your partner.
The HSG and SIS tests are somewhat more invasive than the labs listed above, so I wanted to share some things that I learned firsthand in my testing experiences.
Hysterosalpingogram (HSG)
Summary: The HSG is an X-ray that visualizes the uterus and fallopian tubes, usually performed in a hospital outpatient radiology department. This test will occur between Days 5 and 11 of your cycle.
What to expect: Most women experience mild to moderate cramping during this procedure, and it’s recommended to take 600mg of ibuprofen one hour prior to the test. You’ll be asked to arrive to the test with a full bladder, and to provide a urine sample upon arrival. A speculum is inserted into the vagina so the cervix can be visualized, and a narrow tube will be inserted into the opening of the cervix, where contrast solution is injected into the uterus. You’ll likely feel cramping and discomfort. As the solution is injected, the radiologist will take a series of x-ray pictures.
Tips: Take slow, deep breaths to help relax during the test. You will likely experience cramping for a few hours after the test. Heating pads or warm baths can both feel helpful. Lying flat should also help.
Saline Infusion Sonohysterogram (SIS)
Summary: The SIS is an ultrasound that visualizes the uterus and fallopian tubes, usually performed in your doctors office by a physician or nurse practitioner. This test will occur between Days 5 and 11 of your cycle.
What to expect: Like the HSG, most women experience mild to moderate cramping during this procedure, and it’s recommended to take 600mg of ibuprofen one hour prior to the test. You’ll be asked to arrive to the test with a full bladder, and to provide a urine sample upon arrival. A speculum is inserted into the vagina so the cervix can be visualized, and a narrow tube will be inserted into the opening of the cervix. The speculum is then removed, and the ultrasound probe is inserted into the uterus. Saline will be injected into the uterus, which may cause cramping, but is more subtle than the contrast solution used in the HSG. The physician or nurse practitioner will take a series of sonograph pictures, after which the cannula is removed and the saline will drain out.
Tips: Deep breathing is helpful upon insertion of the speculum and injection of the saline solution. Bring with a pad, and wear older underwear, as you will leak saline for a few hours after the ultrasound. This is completely normal (although a very weird sensation).
If you have any additional testing on your mind or suggested from your physician, I’m happy to review a summary of the test as well as any recommendations I can offer you beforehand.
Friends, you’re not alone in any part of this journey!
*Resource: https://fertility.nm.org/pre-treatment.html
