Basic blood work to assess your ovarian function include Cycle Day 3 labs. Follicle stimulating hormone, estradiol and luteinizing hormone levels are checked Day 3 of your cycle, with day 1 being the first day you start your period. Thyroid stimulating hormone, prolactin, antimullerian hormone levels and a rubella titer are also frequently tested. Depending on you and your partner's genetic history, your provider may have additional recommendations for blood work that would be determined at the time of your appointment.
Knowledge of whether and when ovulation occurs is essential to fertility. Identifying the time when ovulation is likely to occur allows for proper planning of intercourse or intrauterine insemination when fertility is optimal. A simple method of estimating the time of ovulation is charting daily oral temperatures. A woman's temperature is lower during the first part of the menstrual cycle than it is during the last 2 weeks. The temperature shift occurs near ovulation. Ovulation is assumed to occur when there is a rise of 0.4 to 0.6°F or more between 24 hour readings. Use a metabolic thermometer or a digital thermometer with a Fahrenheit scale to check your temperature each morning. Your temperature should be taken each morning immediately after waking, before getting out of bed, eating, drinking, smoking or undertaking any type of physical activity. If using a metabolic thermometer, you should take your temperature for 5 minutes before getting a reading. You should start charting your temperature Day 3 of your cycle, with Day 1 being the first day you start your period. Please make notes on your chart regarding any illness, additional medication or unusual symptoms that month. Your nurse can provide you with blank charts for tracking or there are also websites and smart phone applications that allow you to track your temperature.
A hysterosalpingogram is an x-ray of your uterus and fallopian tubes, where a dye is used to assess for any structural abnormalities. This procedure is done days 7 through 12 of your cycle at Maine Medical Center X Ray Department Bramhall Campus in the early morning. If your provider has recommended this test for you, you will need to call the office day 1 of your cycle, the first day of your period, to schedule. During the procedure you can experience some cramping, so we recommend that you take 600 to 800 mg of ibuprofen the night before and the morning of the procedure. Your provider will be able to discuss the results of this test with you at the time that it is performed.
Because fertility issues can be of female and male origin, often your provider will recommend a semen analysis for your partner. A semen analysis looks at the following: sperm count, motility (the ability of the sperm to swim), the velocity or forward progression of the sperm, the size and shape of the sperm (morphology), total semen volume and the liquefaction of the semen (the ability to go from normal gel-like state at ejaculation to a liquid state). A semen analysis does require an appointment with the lab and your partner will need to create a chart in our electronic medical record, with their demographic and insurance information, prior to the appointment. The semen sample is to be obtained after 48 hours of abstaining from ejaculation and must be collected in a sterile cup. Our office can provide you with this sterile container. The instructions for collection and transportation are very detailed and a copy of these instructions can be obtained from a nurse in the office and can also be located in the "Fertility" section of our website, under the "Patient Forms and Information".