Question
31yo, G0P000, is being evaluated in your clinic for infertility. She and her partner have been trying for 3 years to conceive and have not been successful. She report her partner has already had a semen analysis performed and was within normal limits. She reports a regular menstrual cycle, with little to no variability, and normal flow. She has not been on any form of contraception for 3 years. The rest of her past medical history and family history is benign.
What are types of studies that can be used in her infertility work-up?
Answer
- Assessment of Ovulatory Function
- Mid-luteal phase serum progesterone typically drawn seven days prior to the start of her menstrual cycle
- > 3 ng/mL = recent ovulation
- Mid-luteal phase serum progesterone typically drawn seven days prior to the start of her menstrual cycle
- Assessment of Ovarian Reserve
- Anti-müllerian hormone (AMH) reflects the size of the follicle pool
- Clomiphene citrate challenge test (CCCT)
- 100mg clomiphene on day 5-9 and measurement of day 3 and day 10 FSH and day 3 estradiol
- Assessment of Fallopian Tube Patency
- Hysterosalpingogram
- Assessment of Uterine Cavity
- can be assessed via HSG, but can also be assessed with a saline-infusions sonohysterography or hysteroscopy
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