Fertility Assessment

In up to 20 percent of infertile couples, ovulation problems that prevent the woman from ovulating eggs (anovulation) are present. This makes performing an ovulatory function evaluation a crucial initial step when investigating the source of your infertility. By closely monitoring your ovulation cycle, the specialists at Kofinas Fertility Group in New York can detect improper functioning and give you targeted treatment to improve your fertility.

Ovulation evaluation is the first step toward a successful pregnancy.

At the beginning of the menstrual cycle, an egg forms in the ovary. The eventual release of the egg is called ovulation. As the egg travels through the fallopian tubes into the uterus, the uterus produces the hormone progesterone to prepare the lining of the uterus for the implantation of a fertilized egg.

During your ovulatory function evaluation, we will perform one or more of the following tests in order to give us an accurate picture of your menstrual cycle:

• Basal body temperature (BBT) – Typically, a woman’s body temperature rises slightly around 24 hours after ovulation. By using a graph to track a woman’s body temperature, we can review the timing of other tests and intercourse/insemination.
• Endometrial biopsy – We remove a small sample of the lining of the uterus and examine it under a microscope. This enables us to detect problems with the uterus that can prevent the successful implantation of a fertilized egg.
• Serum progesterone test – Because progesterone increases after ovulation, monitoring your progesterone levels helps us track your ovulation cycle and allows us to determine if sufficient progesterone levels are present to properly prepare the uterus for implantation of the embryo.
• Hormone testing – Besides progesterone, other hormones such as prolactin and thyroid hormones can also affect the ovulation cycle.

After we perform the necessary tests, our insight into your ovulation cycle will allow us to proceed with the care that will best improve your fertility according to your specific needs. You and your future child are our primary concerns, and we will keep you fully informed of the meaning of your test results, as well as our rationale for the next step in your treatment.

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For more information about our ovulatory function evaluation process, or to schedule an appointment, call 718-736-2218. You can also request an appointment using our easy online form.

At Kofinas Fertility Group in New York, we’re able to incorporate advanced imaging techniques into your fertility assessment process in order to give us a clear view of your reproductive system and identify any abnormalities that could be causing fertility issues. We purchase only the best equipment available and are well trained in its use, which allows us to collect the most accurate and useful diagnostic information possible. With a clear picture of your reproductive tract, we have a strong basis for identifying your problem, solving your fertility issues, and giving you the family you’ve always wanted.

Noninvasive ultrasound exams help us solve your fertility issues.

Adhesions and abnormal growths, such as fibroids and polyps, can develop within the uterine cavity and cause or contribute to fertility problems. Using a noninvasive transvaginal ultrasound, our doctors can view the inside of your uterus in real-time and detect any abnormalities. And when we say “our doctors,” we mean that literally –– your fertility specialist will be the one performing your ultrasound, never a technician.

Because ultrasound waves develop a moving image, they are best viewed in real-time, not as still images provided to your physician after the exam. With our doctors controlling the ultrasound, they can control the focus of the images and investigate anything suspicious immediately during the exam.

Depending on where you are in your menstrual cycle (and if it is a normal 28-day cycle or not), other imaging techniques such as a hysterosalpingogram (HSG) and hysterosonogram (HSN) will be scheduled out in order to rule out any blockages in your uterus and/or fallopian tubes. This helps maintain the high-quality care standard set by Kofinas Fertility Group, and it contributes to our excellent diagnostic and treatment success.

Customizing your treatment plan with X-ray technology.

An advanced imaging technique used by Kofinas Fertility Group is a hysterosalpingogram (HSG). By using a special form of x-ray called fluoroscopy and a contrast material, an HSG creates a live image of your uterus and fallopian tubes to help identify damage, blockages, abnormal uterus shape, and other potential problems with your fertility. Our doctors will fill your uterus with a radiographic contrast agent and watch its distribution via the X-ray image. By doing so, we can evaluate the function of your reproductive tract.

Another advanced imaging technique without the use of an x-ray is a hysterosonogram (HSN), or saline infusion sonogram. By infusing sterile fluid into the uterus, it allows our doctors to see if there are any obstructions or abnormalities preventing an embryo from attaching.

Finding out the cause(s) of your fertility problems in a precise, reliable manner is what’s most important to us during these exams. Every possible step will be taken to ensure your comfort while delivering accurate results. We will carefully walk you through each exam, and because we have some of the best talent available, you can trust us to figure out the optimal solution to your problems while giving you the compassionate care that we’re known for.

After your initial exam, the experts at Kofinas Fertility Group in New York will begin ruling out potential sources of your fertility problems. By examining different bodily fluids for any indicators of fertility interference, we can deliver targeted treatment in order to finally give you a successful pregnancy. Our specialists are well trained at examining the data collected from your samples, and they will review your results with you in a clear, accessible manner.

In order to streamline your care, you and your fertility specialist will go over the results together. By going over all the results with your fertility team during your discussion appointment, there’s no need to keep track of lots of individual results and will leave with an individualized treatment plan that brings you closer to achieving your goals.

All successful pregnancies start with a healthy uterus.

We may need to test the lining of your uterus, called the endometrium, for any abnormalities that could be preventing a successful pregnancy. We conduct this test by removing a small sample of the endometrium and examining it under a microscope. The results will let our doctors know if your uterus is capable of sustaining a pregnancy. Depending on your individual problem, we offer many solutions, and finding one that meets your goals is both our expertise and our passion.

Endometrial biopsy

Another sample test that our fertility specialists perform is an endometrial biopsy. An endometrial biopsy is a test that that looks for inflammation (endometritis) and infections inside the uterus by inserting a thin, flexible tool to take a small tissue sample from the lining of your uterus (endometrium). The endometrial tissue is then viewed under a microscope to check for any abnormalities that may lead to failed IUI or IVF cycles in the future or may shed some light on failed attempts in the past.

Making sure your hormones are ideal for having a child.

A variety of hormone imbalances can contribute to infertility in both men and women. Through a simple blood test, we can check your hormone levels and evaluate the extent to which they’re affecting your fertility. Some of the hormones we look at include the following:

• Follicle-stimulating hormone (FSH) – In women, an FSH test is done to evaluate egg supply. In men, the test is used to check for testicular dysfunction as a cause for low sperm count.
• Estradiol – Estradiol is a form of estrogen that affects ovarian function and the quality of your eggs.
• Luteinizing hormone (LH) – This hormone is involved with ovarian hormone production, egg maturation and sperm production. We conduct an LH test to evaluate a woman’s egg supply and a man’s sperm count, or to monitor ovulation.
• Progesterone – Progesterone prompts the endometrium to thicken in preparation for sustaining a pregnancy. Problems with progesterone could mean there is a problem with ovulation or the woman’s uterine lining.
• Prolactin – In women, prolactin abnormalities can cause a range of issues, including infertility problems, lack of menstruation and nipple discharge. For men, a lack of sexual desire or difficulty achieving erection could indicate a problem with prolactin.
• Testosterone – Sexual function in both men and women is affected by testosterone. Men with low testosterone can have low sex drive, an inability to get an erection, or infertility. Women will often have irregular periods or a low sex drive.

Your doctor will use your symptoms to determine the necessity of these tests. During each exam, you will be treated with the utmost professionalism and sensitivity — we understand the emotional stress that can be caused by fertility problems, and we’re confident that we can help you start the life you want and leave your uncertainty behind.

Sperm analysis is an easy way to investigate your fertility.

As male and female infertility tend to appear at equal rates, a semen analysis is a relatively simple test that we use to quickly eliminate or confirm possible sources of male fertility problems. You may either provide your semen sample at home or in one of our designated rooms at Kofinas Fertility Group, and we will analyze the sample in our on-site lab.

We check the following properties during your semen analysis:

• Sperm count and concentration
• Swimming ability (motility)
• Volume of semen
• Appearance
• Fructose level
• pH
• Liquidity of semen
• Number of sperm per milliliter of semen in one ejaculate
• Total number of motile sperm in one ejaculate

If our analysis indicates any abnormalities, your skilled physician will work with you to create a personalized plan that addresses your needs.