Wednesday, April 28, 2010

Testing, 1, 2, 3: Preliminary Tests Before IVF

One of the first things your RE will do is to run a few preliminary tests to help determine what may be preventing you from getting pregnant or staying pregnant. I'm hoping that by this point you had your OB/GYN run the baseline hormone tests (FSH, E2, P4, LH), but if not, then your RE will definitely do so.

Next, she/he will do an ultrasound and check if there are any visible cysts, polyps or anything out of the ordinary. If your RE discovers cysts on your ovaries, you are most likely suffering from Polycystic Ovarian Syndrome (PCOS), which can result in anovulation and is a common cause of infertility.

You will be asked to make an appointment for a hysterosalpingogram (HSG) where your RE will inject a contrast dye that will flow through your fallopian tubes to provide a clear picture of your tubes and uterus. An HSG is done 2 to 5 days after your period has ended but prior to ovulation. This is an uncomfortable procedure (you will not be put under) and some might say, a bit painful. Come prepared with a sanitary pad, some Tylenol and ideally take the rest of the afternoon off. Don't skip this test; it allows your RE to see if your tubes are open and to rule out uterine abnormalities like polyps, adhesions or fibroids.

As I'd stated in my last entry, it's important that you write down your conception journey and provide your records from your OB/GYN. Certain causes of infertility are not easily detectable from a simple ultrasound or blood tests; that's where your personal history comes in. Endometriosis (Endo) is one of them. It usually presents itself in the form of very painful periods, frequent miscarriages and heavy periods, and sometimes, nothing at all. Endo cannot be completely diagnosed and/or treated without a laparoscopy, which isn't part of the preliminary tests that your RE will order. But if you have experienced some of its symptoms, your RE may want to do a laparoscopy to confirm Endo and clean it out.

Another test that not all REs will do is an endocrine test to look at your thyroid function. Thyroiditis is a common problem and can lead to several other issues such as excessive weight gain or weight loss, and of course can affect your ovarian function (anovulation being one of its results). So if your RE doesn't run this test, then make an appointment with an endocrinologist ASAP. It's a simple blood test that can be done at any time of your cycle and the results will be available within a couple of days.

Last, but not least, your partner must get a semen analysis. The test can be done on the same day as your first consultation with your RE or he can come back on another day. But my advice would be to have him provide a sample on the same day as your consult -- he's already there, he can't run away. Get him tested. For that, make sure that he hasn't ejaculated in at least 48 hours but no more than 72 hours. If you read my first entry, you know why.

I will discuss many of the above possible outcomes and test in greater detail in my upcoming posts. Until then, remember that these tests (could) hold the key to unlock your infertility. Being able to finally determine the cause(s) of what's been preventing you from having your baby will empower you.


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