Testing
Testing
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Clomiphene Citrate Challenge Test
The Clomiphene Citrate Challenge Test (CCCT) is a sensitive way to measure a woman’s “ovarian reserve”, that is, whether she has sufficient eggs within her ovaries likely to respond to ovarian stimulating hormones. CCCT is a more sensitive alternative to the simple measurement of blood follicular stimulating hormone (FSH) and estradiol levels on day 2 or day 3 of the menstrual cycle. Results of this test will help you and your physician evaluate your ovarian reserve and adjust your controlled ovarian hyperstimulation plan accordingly.
Cycle Instructions
Day one - Beginning of menses.
Day two or three - FSH and estradiol blood test.
Day five to nine - Take clomiphene 100 mg a day. (Two 50 mg tablets to be taken together at any time of the day. Be consistent with time.)
Day ten - FSH blood test.
You may combine this test of your ovarian reserve with intrauterine insemination to take advantage of the eggs recruited with the clomiphene. You can discuss this option with your coordinator before your cycle begins.
HSG / Saline Sonohysterogram
Hysterosalpingogram (HSG)
The hysterosalpingogram, or HSG, is an X-ray of the uterus and fallopian tubes. The procedure is done at the radiology department and involves injecting a contrast dye into the uterus. It is usually performed after menstrual bleeding has ended and before ovulation occurs. The timing of the procedure allows for optimal viewing of the uterine cavity and the fallopian tubes.
At the time of the test, a special catheter is placed through the vagina and into the cervix. X-ray pictures are then taken as the contrast medium passes through the uterus and this contrast medium will continue out the ends of the fallopian tubes, if they are open. This test helps to determine if the cavity of the uterus is normally shaped and if the tubes are open. It is a short procedure usually taking only 10 to 15 minutes. A second X-ray may be taken one hour after the initial procedure.
During the procedure, you may experience some mild menstrual-like cramps and feel slightly dizzy. Many patients have mild cramping and light bleeding for a day or two after the procedure. These symptoms are normal and are relieved with tylenol or other nonsteroidal anti-inflammatory agents.
If you are allergic to X-ray contrast dye, iodine or shellfish, you may be allergic to the dye used for the HSG. If you develop hives, shortness of breath or a rash, you should tell your nurse or doctor as soon as possible.
Saline Sonohysterogram
The saline sonohysterogram is a sonogram performed while a saline solution is being injected into the uterus. It is also called: Saline Ultrasound, Saline Sonogram, Hysterosonogram, Saline Infusion Sonogram (SIS), or Saline Infusion Sonohysterography.
The sonohysterogram is usually performed after menstrual bleeding has ended and before ovulation occurs. The timing of the procedure allows for optimal viewing of the uterine walls since they are at their thinnest at this point in a woman’s cycle. But this timing may vary depending on what type of investigation it is intended for. Chicago Infertility Associates routinely perform a saline sonohysterogram in our office by our physicians. This allows our physicians to evaluate the uterus for possible causes of infertility, recurrent miscarriage, or abnormal bleeding.
During the examination, the physician inserts a speculum into the vagina as if performing a Pap smear and a very thin catheter is inserted through the cervix into the uterus. This will be followed by inserting a transvaginal ultrasound wand and injection of a small quantity of a saline solution through the catheter. The entire procedure can be completed within 5-10 minutes.
Some patients have mild cramping and light bleeding after the procedure but the symptoms resolve shortly after completion of the examination. These symptoms are normal and are relieved with tylenol or other nonsteroidal anti-inflammatory agents.
Evaluation of Male Factor Infertility
Male partners or sperm donors are critical to the success of fertility care. We begin by providing a detailed evaluation of sperm function. If the specimen is adequate, options include timed intercourse with controlled ovarian hyper stimulation, Intrauterine Insemination (IUI), and In vitro fertilization (IVF).
Male factor infertility is due to challenges with making sperm (low or no sperm count), the ability of the sperm to reach the egg (motility), and fertilization of the egg. There are many treatments to correct these problems, from surgery to general health and lifestyle changes. Call us
to learn more about testing.
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